nursing case study tests

How to Write a Nursing Case Study Paper (A Guide)

Most nursing students dread writing a nursing case study analysis paper, yet it is a mandatory assignment; call it a rite of passage in nursing school. This is because it is a somewhat tricky process that is often overwhelming for nursing students. Nevertheless, by reading this guide prepared by our best nursing students, you should be able to easily and quickly write a nursing case study that can get you an excellent grade.

How different is this guide from similar guides all over the internet? Very different!

This guide provides all the pieces of information that one would need to write an A-grade nursing case study. These include the format for a nursing case study, a step-by-step guide on how to write a nursing case study, and all the important tips to follow when writing a nursing case study.

This comprehensive guide was developed by the top nursing essay writers at NurseMyGrade, so you can trust that the information herein is a gem that will catapult your grades to the next level. Expect updates as we unravel further information about writing a nursing case study.

Now that you know you’ve discovered a gold mine , let’s get right into it.

What Is a Nursing Case Study?

A nursing case study is a natural or imagined patient scenario designed to test the knowledge and skills of student nurses. Nursing case study assignments usually focus on testing knowledge and skills in areas of nursing study related to daily nursing practice.

As a nursing student, you must expect a nursing case study assignment at some point in your academic life. The fact that you are reading this post means that point is now.

While there is no standard structure for writing a nursing case study assignment, some things or elements must be present in your nursing assignment for your professor to consider it complete.

In the next section, you will discover what your instructor n expects in your nursing case study analysis. Remember, these are assignments where you are given a case study and are expected to write a case analysis report explaining how to handle such scenarios in real-life settings.

The Nursing Case Study Template

The typical nursing case study has nine sections. These are:

• Introduction
• Case presentation (Patient info, history, and medical condition)
• Diagnosis/Nursing assessment
• Intervention/Nursing care plan
• Discussion and recommendations

The Structure of a Nursing Case Study Analysis

You now know what nursing professors expect in a nursing case study analysis. In this section, we will explain what to include in each section of your nursing case study analysis to make it an excellent one.

1. Title page

The title page is essential in all types of academic writing. You must include it in your nursing case study analysis or any other essay or paper. And you must include it in the format recommended by your college.

If your college has no specific title page format, use the title page format of the style requested in the assignment prompt. In nursing college, virtually all assignments should be written in Harvard or APA format .

So, check your assignment prompt and create your title page correctly. The typical title page should include the topic of your paper, your name, the name of your professor, the course name, the date you are submitting the paper, and the name of your college.

2. Abstract

Most nursing professors require you to include an abstract in your nursing case study analysis. And even when you are not explicitly required to write one, it is good to do so. Of course, you should consult with your professor before doing so.

When writing an abstract for your paper, make sure it is about 200 words long. The abstract should include a brief summary of the case study, including all the essential information in the patient presentation, such as the history, age, and current diagnosis.

The summary should also include the nursing assessment, the current interventions, and recommendations.

3. Introduction

After writing the title page and the abstract, start writing the introduction. The introduction of a nursing case study analysis must briefly include the patient’s presentation, current diagnosis and medication, and recommendations. It must also include a strong thesis statement that shows what the paper is all about.

You shouldn’t just write an introduction for the sake of it. If you do so, your introduction will be bland. You need to put in good effort when writing your introduction. The best way to do this is to use your introduction to show you understand the case study perfectly and that you will analyze it right.

You can always write your introduction last. Many students do this because they believe writing an introduction last makes it more precise and accurate.

4. Case Presentation (Status of the Patient)

After introducing your nursing case study analysis, you should present the case where you outline the patient's status. It is usually straightforward to present a case.

You must paraphrase the patient scenario in the assignment prompt or brief. Focus on the demographic data of the patient (who they are, age, race, height, skin tone, occupation, relationships, marital status, appearance, etc.), why they are in the case study or scenario, reasons they sought medical attention, chief complaint, and current diagnosis and treatment. You should also discuss the actions performed on the patient, such as admission to the ICU, taking vital signs, recommending tests, etc.

In short, everything necessary in the patient scenario should be in your case presentation. You only need to avoid copying the patient scenario or case study word-for-word when writing your case presentation.

5. Diagnosis and Assessment

After the case presentation, you should explain the diagnosis. In other words, you should explain the condition, disease, or medical situation highlighted in the case presentation. For example, if the patient is a heavy smoker and he has COPD, it is at this point that you explain how COPD is linked to heavy smoking.

This is the section where you thoroughly discuss the disease process (pathophysiology) by highlighting the causes, symptoms, observations, and treatment methods. You should relate these to the patient’s status and give concrete evidence. You should describe the progression of the disease from when the client was admitted to a few hours or days after they were stabilized. Consider the first indication of the disease that prompted the patient to seek further medical assistance.  

Your paper should also elucidate the diagnostic tests that should be conducted and the differential diagnosis. Ensure that each is given a well-founded rationale.

When explaining the condition, go deep into the pathophysiology. Focus specifically on the patient’s risk factors. Ensure you get your explanation from recent nursing literature (peer-reviewed scholarly journals published in the last 5 years). And do not forget to cite all the literature you get your facts from.

In short, this section should explain the patient’s condition or suffering.

6. Nursing Intervention

After the diagnosis and nursing assessment section, your nursing case study analysis should have an intervention section. This section is also known as the nursing care planning section. What you are supposed to do in this section is to present a nursing care plan for the patient presented in the patient scenario. You should describe the nursing care plan and goals for the patient. Record all the anticipated positive changes and assess whether the care plan addresses the patient's condition.

A good nursing care plan details the patient’s chief complaints or critical problems. It then describes the causes of these problems using evidence from recent medical or nursing literature. It then details the potential intervention for each problem. Lastly, it includes goals and evaluation strategies for the measures. Most professors, predominantly Australian and UK professors, prefer if this section is in table format.

Some nursing professors regard the intervention section (or nursing care plan section) as the most critical part of a nursing case study. This is because this part details precisely how the student nurse will react to the patient scenario (which is what the nursing professors want to know). So, ensure you make a reasonable effort when developing this section to get an excellent grade.

7. Discussion and Recommendations

The intervention section in a nursing case study is followed by a discussion and recommendations section. In this section, you are supposed to expound on the patient scenario, the diagnosis, and the nursing care plan. You should also expound on the potential outcomes if the care plan is followed correctly. The discussion should also explain the rationale for the care plan or its significant bits.

Recommendations should follow the discussion. Recommendations usually involve everything necessary that can be done or changed to manage a patient’s condition or prevent its reoccurrence. Anything that enhances the patient’s well-being can be a recommendation. Just make sure your key recommendations are supported by evidence.

8. Conclusion

This is the second last section of a typical nursing case study. What you need here is to summarize the entire case study. Ensure your summary has at least the case presentation, the nursing assessment/diagnosis, the intervention, and the key recommendations.

At the very end of your conclusion, add a closing statement. The statement should wrap up the whole thing nicely. Try to make it as impressive as possible.

9. References

This is the last section of a nursing case study. No nursing case study is complete without a references section. You should ensure your case study has in-text citations and a references page.

And you should make sure both are written as recommended in the assignment. The style section is usually Harvard or APA. Follow the recommended style to get a good grade on your essay.

Step-By-Step Guide to Writing a Nursing Case Study

You know all the key sections you must include in a nursing case study. You also know what exactly you need to do in each section. It is time to learn how to write a nursing case study. The process detailed below should be easy to follow because you know the typical nursing case study structure.

1. Understand the Assignment

When given a nursing case study assignment, the first thing you need to do is to read. You need to read two pieces of information slowly and carefully.

First, you need to read the prompt itself slowly and carefully. This is important because the prompt will have essential bits of information you need to know, including the style, the format, the word count, and the number of references needed. All these bits of information are essential to ensure your writing is correct.

Second, you need to read the patient scenario slowly and carefully. You should do this to understand it clearly so that you do not make any mistakes in your analysis.

2. Create a Rough Outline

Failure to plan is a plan to fail. That is not what you are in it for anyway! In other words, do not fail to create an outline for your case study analysis. Use the template provided in this essay to create a rough outline for your nursing case study analysis.

Ensure your outline is as detailed as it can be at this stage. You can do light research to achieve this aim. However, this is not exactly necessary because this is just a rough outline.

3. Conduct thorough research

After creating a rough outline, you should conduct thorough research. Your research should especially focus on providing a credible and evidence-based nursing assessment of the patient problem(s). You should only use evidence from recent nursing or medical literature.

You must also conduct thorough research to develop an effective intervention or nursing care plan. So when researching the patient’s problem and its diagnosis, you should also research the most suitable intervention or do it right after.

When conducting research, you should always note down your sources. So for every piece of information you find, and what to use, you should have its reference.

After conducting thorough research, you should enhance your rough outline using the new information you have discovered. Make sure it is as comprehensive as possible.

4. Write your nursing case study

You must follow your comprehensive outline to write your case study analysis at this stage. If you created a good outline, you should find it very easy to write your nursing case study analysis.

If you did not, writing your nursing case study will be challenging. Whenever you are stuck writing your case study analysis paper, you should re-read the part where we explain what to include in every section of your analysis. Doing so will help you know what to write to continue your essay. Writing a nursing case study analysis usually takes only a few hours.

5. Reference your case study

After writing your case study, ensure you add all in-text citations if you have not already. And when adding them, you should follow the style/format recommended in the assignment prompt (usually APA or Harvard style).

After adding in-text citations exactly where they need to be and in the correct format, add all the references you have used in a references page. And you should add them correctly as per the rules of the style you were asked to use.

Do not forget to organize your references alphabetically after creating your references page.

6. Thoroughly edit your case study

After STEP 5 above, you need to edit your case study. You should edit it slowly and carefully. Do this by proofreading it twice. Proofread it slowly each time to discover all the grammar, style, and punctuation errors. Remove all the errors you find.

After proofreading your essay twice, recheck it to ensure every sentence is straightforward. This will transform your ordinary case study into an A-grade one. Of course, it must also have all the standard sections expected in a case study.

Recheck your case study using a grammarly.com or a similar computer grammar checker to ensure it is perfect. Doing this will help you catch and eliminate all the remaining errors in your work.

7. Submit your case study analysis

After proofreading and editing your case study analysis, it will be 100% ready for submission. Just convert it into the format it is required in and submit it.

 Nursing Case Study Tips and Tricks

The guide above and other information in this article should help you develop a good nursing case study analysis. Note that this guide focuses entirely on nursing case scenario-based papers, not research study-based nursing case studies. The tips and tricks in this section should help you ensure that the nursing case study analysis you create is excellent.

1. Begin early

The moment you see a nursing case study assignment prompt, identify a date to start writing it and create your own deadline to beat before the deadline stated in the prompt.

Do this and start writing your case study analysis early before your deadline. You will have plenty of time to do excellent research, develop an excellent paper, and edit your final paper as thoroughly as you want.

Most student nurses combine work and study. Therefore, if you decide to leave a nursing case study assignment until late to complete it, something could come up, and you could end up failing to submit it or submitting a rushed case study analysis.

2. Use the proper terminology

When writing an essay or any other academic paper, you are always encouraged to use the most straightforward language to make your work easy to understand. However, this is not true when writing a nursing case study analysis. While your work should certainly be easy to understand, you must use the right nursing terminology at every point where it is necessary. Failure to do this could damage your work or make it look less professional or convincing.

3. Avoid copying and pasting

If you are a serious nursing student, you know that copying and pasting are prohibited in assignments. However, sometimes copying and pasting can seem okay in nursing case studies. For example, it can seem okay to copy-paste the patient presentation. However, this is not okay. You are supposed to paraphrase the verbatim when presenting the patient presentation in your essay. You should also avoid copy-pasting information or texts directly. Every fact or evidence you research and find should be paraphrased to appear in your work. And it should be cited correctly.

4. Always ask for help if stuck

This is very important. Students are usually overwhelmed with academic work, especially a month or two to the end of the semester. If you are overwhelmed and think you will not have the time to complete your nursing case study analysis or submit a quality one, ask for help. Ask for help from a nursing assignment-help website like ours, and you will soon have a paper ready that you can use as you please. If you choose to get help from us, you will get a well-researched, well-planned, well-developed, and fully edited nursing case study.

5. Format your paper correctly

Many students forget to do proper formatting after writing their nursing case study analyses. Before you submit your paper, make sure you format it correctly. If you do not format your paper correctly, you will lose marks because of poor formatting. If you feel you are not very confident with your APA or Harvard formatting skills, send your paper to us to get it correctly formatted and ready for submission.

Now that you are all set up …

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We have experienced nursing experts available every day of the week to provide nursing assignment help. They can easily research and write virtually any nursing assignment, including a nursing case study. So, if the information provided in this article isn’t making you feel any optimistic about writing an excellent nursing case study, get help from us.

Get help by ordering a custom nursing case study through this very website. If you do so, you will get a 100% original paper that is well-researched, well-written, well-formatted, and adequately referenced. Since the paper is original, you can use it anywhere without problems.

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State Resources

National Resources

Nursing Organizations

• MNWC Initiatives

Maryland Nursing Workforce Center

• NextGen NCLEX

Faculty Case Studies

The purpose of this project was to develop a repository of NextGen NCLEX case studies that can be accessed by all faculty members in Maryland.

Detailed information about how faculty members can use these case students is in this PowerPoint document .

The case studies are in a Word document and can be modified by faculty members as they determine. 

NOTE: The answers to the questions found in the NextGen NCLEX Test Bank  are only available in these faculty case studies. When students take the Test Bank questions, they will not get feedback on correct answers. Students and faculty should review test results and correct answers together.

The case studies are contained in 4 categories: Family (13 case studies), Fundamentals and Mental Health (14 case studies) and Medical Surgical (20 case studies). In addition the folder labeled minireviews contains PowerPoint sessions with combinations of case studies and standalone items. 

Family  ▾

• Attention Deficit Hyperactivity Disorder - Pediatric
• Ectopic Pregnancy
• Febrile Seizures
• Gestational Diabetes
• Intimate Partner Violence
• Neonatal Jaundice
• Neonatal Respiratory Distress Syndrome
• Pediatric Hypoglycemia
• Pediatric Anaphylaxis
• Pediatric Diarrhea and Dehydration
• Pediatric Intussusception
• Pediatric Sickle Cell
• Postpartum Hemmorhage
• Poststreptococcal Glomerulonephritis Pediatric
• Preeclampsia

Fundamentals and Mental Health  ▾

• Abdominal Surgery Postoperative Care
• Anorexia with Dehydration
• Catheter Related Urinary Tract Infection
• Deep Vein Thrombosis
• Dehydration Alzheimers
• Electroconvulsive Therapy
• Home Safety I
• Home Safety II
• Neuroleptic Maligant Syndrome
• Opioid Overdose
• Post Operative Atelectasis
• Post-traumatic Stress
• Pressure Injury
• Substance Use Withdrawal and Pain Control
• Suicide Prevention
• Tardive Dyskinesia
• Transfusion Reaction
• Urinary Tract infection

Medical Surgical  ▾

• Acute Asthma
• Acute Respiratory Distress
• Breast Cancer
• Chest Pain (MI)
• Compartment Syndrome
• Deep Vein Thrombosis II
• End Stage Renal Disease and Dialysis
• Gastroesphageal Reflux
• Heart Failure
• HIV with Opportunistic Infection
• Ketoacidosis
• Liver Failure
• Prostate Cancer
• Spine Surgery
• Tension Pneumothorax
• Thyroid Storm
• Tuberculosis

Community Based  ▾

Mini Review  ▾

• Comprehensive Review
• Fundamentals
• Maternal Newborn Review
• Medical Surgical Nursing
• Mental Health Review
• Mini Review Faculty Summaries
• Mini Review Training for Website
• Mini Reviews Student Worksheets
• Pediatric Review

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Next Generation NCLEX Study Tips for Case Studies

In April of 2023, the NCSBN released the new version of the NCLEX exam, which is called the Next Generation NCLEX (or NGN, for short). One of the big changes with the Next Generation NCLEX was the introduction of case studies .

These new changes have caused some students and new graduates to become nervous, and some are wondering how they should be preparing for this new format.

Study Tips for Next Generation NCLEX Case Studies

What should your study plan be for the Next Generation NCLEX case studies?

First, let’s think about what’s different about a case study. A case study is going to give you a scenario of how a patient may present with a particular disease(s), and it’s going to walk you through a scenario of what may happen as the patient progresses.

These case studies are going to test your nursing knowledge on how to identify important symptoms, lab reports, what to watch for, how to deliver care, and provide patient education.

In other words, case studies are very similar to how things really work in the real world of nursing!

So the big question is how do you prepare for these case studies on the NGN?

Familiarize Yourself with NGN Case Studies

First, you’ll want to familiarize yourself with this new case study format so that you’ll understand how they work.

I developed a mock Next Generation NCLEX case study , and in that case study, I walk you through the sample questions step-by-step. I highly recommend you watch that video because it’s going to show you how to think critically as you answer these new NGN questions.

The Secret to Case Studies

As you prepare for case studies, you have to understand that merely memorizing a few facts about a disease will not work well to prepare you for these questions. Instead, you truly have to understand the material in a deeper way so that you are able to connect the dots and answer the different scenarios that might pop up.

To do this, I like to compare a disease to an onion. And just as onions have many different layers, there are many layers of what’s going on with a disease process, too. As you begin pulling back the layers of a disease, you can get to the core of what’s happening to your patient and see the domino effect that occurs.

But you have to go through those layers to get to that core. But if you skip those layers, you’re going to be missing things, and it is going to make these case studies much more difficult.

And the “layers” I’m referring to can be things like the pathophysiology, signs and symptoms, labs and diagnostics, treatment, medications, and your role as the nurse.

And you’ll want to be familiar with all of those different layers, because that will allow you to easily connect the dots and breeze through these case study questions.

Study Example for Case Study of Heart Failure

To illustrate my point, consider a case study over a h eart failure patient . The first “layer” you’d want to peel back as you study is the PATHO!

Layer 1: Understand the Pathophysiology

I cannot emphasize enough that taking time to really dig into the pathophysiology of a disease will really help you understand what’s happening and why, which will be crucial in helping you understand how the different body systems are affected.

As you study, you want to ask yourself, “What’s occurring in the body? Which systems are affected? What causes this, and why?”

This step will take a lot of energy and time on your part, but in my opinion, it’s one of the best uses of your study time. Once you truly grasp this part, it will have a “domino effect” of helping you connect the dots.

Layer 2: Allow the Signs and Symptoms to Flow from the Patho

When you truly understand the patho of a disease, the signs and symptoms will easily fall into place. In many cases, you won’t even need to spend time memorizing a list of signs and symptoms for a disease! Understanding the patho will help you easily piece that together in your mind.

For example, in heart failure, you know we have a fluid volume overload . If the heart failure is on the right side, it’s going to cause a backup of fluid that can lead to things like JVD (jugular venous distention), ascites, edema, and enlarged liver.

If the heart failure is on the left side, it’s going to be affecting the lungs, leading to things like shortness of breath, crackles , orthopnea, difficulty breathing at night, and even pulmonary edema.

Layer 3: Determine Relevant Labs and Diagnostics

Next, I’d recommend focusing on the relevant labs and diagnostic reports. Even though we don’t order these as the nurse, they are very important to us because we need to know what we need to monitor for and what should be expected for that patient.

And the abnormal signs and symptoms you just learned about will go along with those labs and diagnostic reports. It’s all going to click and make sense.

Layer 4: The Patient’s Plan of Care

Those layers will then feed right into the patient’s plan of care. As you study, be asking yourself, “What do I expect the doctor to order? What are the common medications and procedures?”

One you peel back this layer, it will make your job as the nurse very easy to understand because what we do a nurses goes right along with the treatments ordered.

Layer 5: Focus on What We Do (and Don’t Do) for the Patient

In this final layer, you’ll want to be thinking about what you would and wouldn’t do for the patient. For example, think of questions such as, “What’s going to help this patient get better? What should I monitor? What should I report? What important patient education should I provide?”

With medications, for what side effects are you going to be monitoring? If a patient with heart failure is on loop diuretics , what side effects could occur? You’re going to look at urinary output, electrolytes (particularly the potassium level).

You’ll also want to consider information you’ll provide to the patient throughout their stay, along with discharge education points and care.

Conclusion of Study Tips for NGN Case Studies

In summary, the best way to prepare for the case studies on the Next Generation NCLEX is to actually understand the disease holistically, which means digging into the pathophysiology first, and then allowing that to flow to the signs and symptoms, medications, patient education, and so forth.

By taking the time to absorb the material, and digging deep in to the disease process, it’s going to pay off big when it comes time to answer these questions that evolve and require a deeper level of critical thinking.

That’s why I always try to take the time to cover these important concepts in my NCLEX review lectures on YouTube . I really try to help students connect the dots and understand these diseases in a way that will click and make it easier to remember, both on exams and in the real world of nursing.

Nurse Sarah’s Notes and Merch

Just released is “ Fluid and Electrolytes Notes, Mnemonics, and Quizzes by Nurse Sarah “. These notes contain 84 pages of Nurse Sarah’s illustrated, fun notes with mnemonics, worksheets, and 130 test questions with rationales.

You can get an eBook version here or a physical copy of the book here.

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Nursing Case Studies with Answers

Explore Nursing Case Studies with Answers and examples in Carepatron's free downloadable PDF. Enhance your nursing knowledge and prepare for exams with practical scenarios.

By Wynona Jugueta on Jun 03, 2024.

Fact Checked by Ericka Pingol.

What is a case study?

A case study in medicine is a detailed report of a patient's experience with a disease, treatment, or condition. It typically includes the patient's medical history, symptoms, diagnostic tests, treatment course, and outcome.

Some key things to know about medical case studies template . First, they delve deep into the specifics of a single case, providing a rich understanding of a particular medical situation.

Medical professionals use case studies to learn about rare diseases, unusual presentations of common conditions, and the decision-making process involved in complex cases.

Case studies can identify exciting areas for further investigation through more rigorous clinical trials. While informative, they can't be used to develop general treatment guidelines because they only focus on a single case.

Overall, medical case studies are valuable tools for medical education and research, offering insights into human health and disease complexities.

Printable Nursing Case Studies with Answers

Download this Nursing Case Studies with Answers to analyze complex clinical situations, identify priority needs, and develop effective care plans tailored to individual patients.

What is in a nursing case study?

A nursing case study is a detailed examination of a patient's health condition, treatment plan, and overall care journey, specifically from the perspective of nursing practice. These case studies are essential components of nursing education and professional development, providing valuable insights into clinical scenarios and patient care experiences.

In a case nursing study template , various elements are typically included to comprehensively understand the patient's situation. First and foremost, the case study outlines the patient's demographic information, including age, gender, medical history, and presenting symptoms. This demographic overview sets the stage for understanding the context in which healthcare interventions occur.

Moreover, nursing case studies often delve into the nursing assessment process, highlighting the initial and ongoing assessments nurses conduct to gather relevant patient health status data. These assessments involve physical examinations, vital sign monitoring, and assessment tools to identify potential health issues and risk factors.

Critical thinking skills are essential in nursing case studies, as they enable nurses to analyze complex clinical situations, identify priority needs, and develop effective care plans tailored to individual patients. Nursing students and experienced nurses use case studies as opportunities to enhance their critical thinking abilities and clinical decision-making processes.

Nursing case studies serve several vital purposes within healthcare education and professional practice, whether they are a primary care physician or a group of nursing students. Let's explore each purpose in detail:

Enhancing clinical reasoning skills

One primary purpose of nursing case studies is to enhance nursing students' and practicing nurses' clinical reasoning skills. By presenting realistic patient scenarios, case studies challenge individuals to analyze clinical data, interpret findings, and develop appropriate nursing interventions. This process promotes critical thinking and problem-solving abilities essential for effective nursing practice.

Applying theoretical knowledge to practice

Nursing case studies provide a bridge between theoretical knowledge and practical application. They allow nursing students to apply concepts learned in the classroom to real-world patient care situations. By engaging with case studies, students can integrate theoretical principles with clinical practice, gaining a deeper understanding of nursing concepts and their relevance to patient care.

Facilitating interdisciplinary collaboration

Another purpose of nursing case studies is to facilitate interdisciplinary collaboration among healthcare professionals. Nurses often collaborate with physicians, specialists, therapists, and other team members in complex patient cases to deliver comprehensive care. Case studies offer opportunities for nurses to explore collaborative decision-making processes, communication strategies, and teamwork dynamics essential for providing quality patient care.

Promoting evidence-based practice

Nursing case studies are crucial in promoting evidence-based practice (EBP) within nursing and healthcare settings. Nurses can make informed decisions about patient care interventions by analyzing patient scenarios and considering current research evidence. Case studies encourage nurses to critically evaluate research findings, clinical guidelines, and best practices to ensure the delivery of safe, effective, and patient-centered care.

Fostering professional development

Engaging with nursing case studies contributes to the ongoing professional development of nurses at all stages of their careers. For nursing students, case studies provide valuable learning experiences that help prepare them for clinical practice. For experienced nurses, case studies offer opportunities to refine clinical skills, stay updated on emerging healthcare trends, and reflect on past experiences to improve future practice.

How to write a nursing case study?

Writing a nursing case study involves several essential steps to ensure accuracy, relevance, and clarity. Let's break down the process into actionable steps:

Step 1: Select a patient case

Begin by selecting a patient case that presents a relevant and compelling healthcare scenario. Consider factors such as the patient's demographic information, medical history, presenting symptoms (e.g., joint stiffness, pain), and healthcare needs (e.g., medication administration, vital signs monitoring). Choose a case that aligns with your learning objectives and offers meaningful analysis and discussion opportunities.

Step 2: Gather relevant data

Collect comprehensive data about the selected patient case, including medical records, test results, nursing assessments, and relevant healthcare documentation. Pay close attention to details such as the patient's current health status, past medical history (e.g., diabetes), treatment plans, and any ongoing concerns or challenges. Utilize assessment tools and techniques to evaluate the patient's condition thoroughly and identify areas of clinical significance.

Step 3: Assess the patient's needs

Based on the gathered data, evaluate the patient's needs, considering physical, emotional, social, and environmental factors. Assess the patient's pain levels, mobility, vital signs, and other relevant health indicators. Identify any potential complications, risks, or areas requiring immediate attention. Consider the patient's preferences, cultural background, and individualized care requirements in your assessment.

Step 4: Formulate nursing diagnoses

Formulate nursing diagnoses that accurately reflect the patient's health needs and priorities based on your assessment findings. Identify actual and potential nursing diagnoses related to the patient's condition, considering factors such as impaired mobility, ineffective pain management, medication adherence issues, and self-care deficits. Ensure your nursing diagnoses are specific, measurable, achievable, relevant, and time-bound (SMART).

Step 5: Develop a care plan

Develop a comprehensive care plan outlining the nursing interventions and strategies to address the patient's identified needs and nursing diagnoses. Prioritize interventions based on the patient's condition, preferences, and care goals. Include evidence-based nursing interventions to promote optimal health outcomes, manage symptoms, prevent complications, and enhance the patient's overall well-being. Collaborate with other healthcare professionals as needed to ensure coordinated care delivery.

Step 6: Implement and evaluate interventions

Implement the nursing interventions outlined in the care plan while closely monitoring the patient's response to treatment. Administer medications, provide patient education, perform nursing procedures, and coordinate care activities to effectively meet the patient's needs. Continuously evaluate the effectiveness of interventions, reassessing the patient's condition and adjusting the care plan as necessary. Document all interventions, observations, and outcomes accurately and comprehensively.

Step 7: Reflect and seek assistance

Reflect on the nursing case study process, considering what worked well, areas for improvement, and lessons learned. Seek assistance from nursing instructors, preceptors, or colleagues if you encounter challenges or have concerns about the patient's care. Collaborate with interdisciplinary team members to address complex patient issues and ensure holistic care delivery. Continuously strive to enhance your nursing practice through ongoing learning and professional development.

Nursing Case Studies with Answers example (sample)

Below is an example of a nursing case study sample created by the Carepatron team. This sample illustrates a structured framework for documenting patient cases, outlining nursing interventions, and providing corresponding answers to guide learners through the analysis process. Feel free to download the PDF and use it as a reference when formulating your own nursing case studies.

Download this free Nursing Case Studies with Answers PDF example here 

Why use Carepatron as your nursing software?

Carepatron stands out as a comprehensive and reliable solution for nursing professionals seeking efficient and streamlined workflows in their practice. With a range of features tailored to the needs of nurses and healthcare teams, Carepatron offers unparalleled support and functionality for managing various aspects of patient care.

Nurse scheduling software

One of the key advantages of Carepatron is its nurse scheduling software , which simplifies the process of creating and managing schedules for nursing staff. With intuitive scheduling tools and customizable options, nurses can easily coordinate shifts, manage availability, and ensure adequate staffing levels to meet patient needs effectively.

Telehealth platform

In addition, Carepatron offers a robust telehealth platform that facilitates remote patient monitoring, virtual consultations, and telemedicine services. This feature enables nurses to provide continuity of care beyond traditional healthcare settings, reaching patients in remote areas or those unable to attend in-person appointments.

Clinical documentation software

Furthermore, Carepatron's clinical documentation software streamlines the documentation process, allowing nurses to easily capture patient data, record assessments, and document interventions. The platform supports accurate and efficient documentation practices, ensuring compliance with regulatory standards and promoting continuity of care across healthcare settings.

Commonly asked questions

In clinical terms, a case study is a detailed examination of a patient's medical history, symptoms, diagnosis, treatment, and outcomes, typically used for educational or research purposes.

Case studies are essential in nursing as they provide real-life scenarios for nurses to apply theoretical knowledge, enhance critical thinking skills, and develop practical clinical reasoning and decision-making abilities.

Case studies in nursing education offer benefits such as promoting active learning, encouraging problem-solving skills, facilitating interdisciplinary collaboration, and fostering a deeper understanding of complex healthcare situations.

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How to Write a Nursing Case Study Analysis – Guide, Format, and Examples for Nursing Students

Wilson logan.

• August 6, 2022
• Nursing Writing Guides

What is a Nursing Case Study Analysis?

A case study analysis is a detailed examination of a specific real-world situation or event.

It is typically used in nursing school to help students learn how to analyze complex problems and make decisions based on limited information to support nursing care.

Preparing a good case study analysis is difficult and requires much time and effort. This article provides some tips on how to write a case study analysis that will help you get the most out of your research and provide a solid foundation for your writing.

A case study analysis requires you to investigate a nursing scenario, examine the alternative solutions, and propose the most effective solution using supporting evidence.

Nurses constantly make decisions that affect the lives of their patients. Nurses need strong problem-solving and critical-thinking skills to make these decisions correctly. Case studies are an excellent way for nurses to hone these skills.

This guide will help BSN, MSN, and DNP nursing students navigate the process of writing a nursing case study analysis, focusing on the format, steps, and key components.

How do you analyze a case study in nursing?

A nursing case study is an in-depth examination of a single individual. It is usually used to identify new areas of knowledge or to validate existing knowledge.

When analyzing a nursing case study, it is important to consider the following elements:

• The patient’s medical history. This includes any prior illnesses, treatments, and medications.
• The patient’s current condition. This includes symptoms, vital signs, and laboratory results.
• The nurse’s observations. This includes the nurse’s notes on the patient’s condition and behavior.
• The patient’s family and social history. This includes information on the patient’s family, friends, and social support network.
• The patient’s response to treatment, including any changes in the patient’s condition or symptoms after receiving treatment.

How Nursing Practitioners Can Analyze Patient’s Cases

As a nurse practitioner, you will often be asked to provide a case analysis for your patients. This can be a daunting task, but there are some key elements that you should always include in your analysis.

• The first element is the patient history. This should include any relevant medical history and any personal information that may be pertinent to the case.
• The second element is the physical examination. This should include a thorough patient examination, including any relevant test results.
• The third element is the diagnosis. This is where you will assess the patient’s condition and identify potential problems.
• The fourth element is the treatment plan. This is where you will outline the course of treatment you recommend for the patient.
• The fifth and final element is the prognosis. In this section, you will assess the likely outcome of the case based on the information you have gathered.

How to Write a Nursing Case Study Analysis

Format of a nursing case study analysis.

A nursing case study analysis typically follows a standard format, which includes:

• Introduction: Provide a brief overview of the patient, the diagnosis, and the purpose of the case study (Hooper, 2014).
• Patient History: Present the patient’s background, including age, gender, medical history, and any relevant social or family history (Smith, 2017).
• Nursing Assessment: Describe the patient’s current condition, including vital signs, physical examination findings, and any diagnostic tests or procedures (Jones, 2015).
• Nursing Diagnosis: Identify the primary nursing diagnosis based on the assessment findings, using NANDA International terminology (Herdman & Kamitsuru, 2019).
• Care Plan: Develop a comprehensive care plan that addresses the patient’s needs, including nursing interventions, rationale, and expected outcomes (Thompson, 2018).
• Evaluation: Discuss the patient’s response to the interventions and any modifications made to the care plan (Brown, 2016).
• Conclusion: Summarize the key points of the case study and discuss the implications for nursing practice (Davis, 2014).

Steps for conducting a case study in nursing research papers

• Choose a relevant case: Select a patient case that aligns with the purpose of your research paper and highlights important nursing concepts (Taylor, 2015).
• Gather information: Collect data from the patient’s medical record, nursing assessments, and any additional sources, such as interviews with the patient or family members (Wilson, 2017).
• Analyze the data: Identify patterns, trends, and significant findings in the patient’s data to inform your nursing diagnosis and care plan (Lee, 2016).
• Develop a nursing diagnosis: Use the NANDA International taxonomy to formulate a nursing diagnosis that accurately reflects the patient’s condition (Herdman & Kamitsuru, 2019).
• Create a care plan: Develop a comprehensive care plan that addresses the patient’s needs, including specific nursing interventions, rationale, and expected outcomes (Thompson, 2018).
• Evaluate the outcome: Discuss the patient’s response to the interventions and any modifications made to the care plan based on the patient’s progress (Brown, 2016).
• Write the case study: Follow the standard format for a nursing case study analysis, ensuring that each section is well-organized and supported by evidence from primary sources (Hooper, 2014).
• First, you will need to read over the case study thoroughly.
• Ensure you understand all of the information presented in the case study and note any key points or details that may be important.
• Once you understand the case study well, you must start planning your analysis. Consider your overall argument.
• What points do you want to make in your analysis?
• What evidence will you use to support these points?
• Once you have a good idea of what you want to say in your analysis, start organizing your thoughts and putting them into a coherent structure.
• Once you have a rough case study analysis outline, start filling in the details. Flesh out your arguments and provide evidence to support them. In addition, make sure to address any counterarguments that could be made against your points.
• Finally, conclude your analysis by summarizing your main points and providing any recommendations or suggestions for further action.

Presenting a Care plan and Nursing Assessment of the patient in a Case Study

When presenting a care plan and nursing assessment in a case study, it is essential to:

• Use a systematic approach: Follow a standardized format like the Nursing Process to ensure a comprehensive assessment and care plan.
• Include relevant data: Present pertinent information from the patient’s history, physical examination, diagnostic tests, and nursing assessments.
• Prioritize nursing diagnoses: Based on the patient’s condition, identify the most important nursing diagnoses and prioritize them according to urgency and significance.
• Develop patient-centered interventions: Create nursing interventions that are specific, measurable, achievable, relevant, and time-bound (SMART) and tailored to the patient’s individual needs.
• Provide rationale: Explain the reasoning behind each nursing intervention, linking it to evidence-based practice and the expected outcomes.
• Evaluate outcomes: Discuss the patient’s response to the interventions and any modifications made to the care plan based on the patient’s progress.

How to write case study analysis in nursing

To write a case study analysis in nursing, follow these steps:

• Introduction: Begin with a brief overview of the patient, the diagnosis, and the purpose of the case study.
• Patient History: Present the patient’s background, including age, gender, medical history, and any relevant social or family history.
• Nursing Assessment: Describe the patient’s current condition, including vital signs, physical examination findings, and any diagnostic tests or procedures.
• Nursing Diagnosis: Using NANDA International terminology, identify the primary nursing diagnosis based on the assessment findings.
• Care Plan: Develop a comprehensive care plan that addresses the patient’s needs, including nursing interventions, rationale, and expected outcomes.
• Evaluation: Discuss the patient’s response to the interventions and any modifications to the care plan.
• Conclusion: Summarize the key points of the case study and discuss the implications for nursing practice.

How to Structure a Nursing Case Study Analysis Paper

When structuring a nursing case study paper, it is essential to include specific information in each section to ensure a comprehensive and well-organized analysis. Here’s an extensive guide on what should be included in each section of the nursing case study analysis paper:

• The title of the case study should be concise, descriptive, and reflective of its main focus
• Include your name, academic credentials, and the institution where you are studying.
• Provide the date of submission
• Write a brief summary (usually 150-300 words) of the case study
• Include the purpose of the study, the main methods used, key results, and conclusions
• Highlight the most important points that will be discussed in the paper

Introduction

• Provide background information on the patient, including age, gender, and the primary reason for seeking medical care.
• Briefly describe the patient’s diagnosis and any relevant medical history.
• State the purpose of the case study and its significance to nursing practice.

Patient History

• Present a detailed account of the patient’s background, including past medical history, family history, social history, and any relevant lifestyle factors.
• Discuss the patient’s medications, allergies, and recent hospitalizations or surgeries.
• Include pertinent information about the patient’s physical, emotional, and cognitive status.

Nursing Assessment:

• Describe the patient’s condition, including vital signs, physical examination findings, and relevant diagnostic tests or procedures.
• Use a systematic approach, such as the head-to-toe assessment, to ensure a comprehensive patient evaluation.
• Discuss the patient’s chief complaint, symptoms, and any changes in their condition since admission.

Nursing Diagnosis

• Using NANDA International terminology, identify the primary nursing diagnosis based on the assessment findings.
• Provide a clear, concise statement that describes the patient’s health problem or potential risk.
• Include the related factors and defining characteristics that support the nursing diagnosis.
• Based on the nursing diagnosis, develop a comprehensive care plan that addresses the patient’s needs.
• Include specific, measurable, achievable, relevant, and time-bound (SMART) goals for each nursing intervention.
• Explain each intervention’s rationale, explaining how it will help achieve the desired outcomes.
• Discuss the implementation of the interventions, including any collaborative efforts with other healthcare professionals.
• Assess the patient’s response to the nursing interventions and discuss any changes in their condition (Brown, 2016).
• Evaluate the effectiveness of the care plan in achieving the desired outcomes (Wilson, 2017).
• Discuss any modifications to the care plan based on the patient’s progress or changes in their condition (Lee, 2016).
• Reflect on the overall nursing care provided and identify areas for improvement (Jones, 2015).
• Analyze the case study, applying relevant nursing theories and evidence-based practice guidelines.
• Compare the patient’s case to similar cases in the literature and discuss any unique aspects.
• Identify the strengths and weaknesses of the nursing care provided and recommend improvement.
• Discuss the implications of the case study for nursing practice, education, and research.
• Summarize the key points of the case study, including the primary nursing diagnoses, interventions, and outcomes.
• Emphasize the importance of the case study for nursing practice and patient care.
• Provide a final reflection on the learning experience and how it contributes to your growth as a nursing professional.
• List all sources cited in the case study using the appropriate citation style (e.g., APA, MLA).
• Ensure that all references are current, reliable, and relevant to the case study.
• Include a mix of primary and secondary sources, such as research articles, textbooks, and clinical guidelines.

10 Nursing Case Study Examples for Nursing Students

Tips for writing a nursing case study analysis.

When writing a nursing case study analysis, applying your theoretical knowledge, critical thinking skills, and clinical reasoning is essential to provide a thorough and evidence-based evaluation of the patient’s condition. Here are some tips to help you write a comprehensive nursing case study analysis:

• Start with a clear introduction that includes patient information, such as age, gender, and chief complaint. This will give the reader a clear picture of the patient’s background and medical situation.
• Provide a detailed medical history, including any chronic conditions, medications, allergies, and surgeries. This information will help you formulate nursing diagnoses and develop an appropriate nursing care plan.
• Include a family history section to identify any genetic diseases or chronic conditions that may be relevant to the patient’s current condition. This will help you understand potential complications and adjust treatment accordingly.
• Discuss the patient’s social history, including employment status, living situation, and alcohol/drug use. This information can provide insight into the patient’s lifestyle and its impact on their health.
• Perform a thorough physical examination and review of symptoms to identify any abnormalities contributing to the patient’s condition. This will help you determine the need for further medical attention or diagnostic testing.
• Analyze diagnostic test results, such as blood work, imaging tests, and biopsies, to confirm or rule out a diagnosis. This will help you develop an evidence-based treatment plan.
• Develop a comprehensive nursing care plan that includes nursing diagnoses, interventions, and expected outcomes. Ensure that the plan is based on evidence-based guidelines and tailored to the patient’s specific needs.
• Describe the rationale behind each intervention in the nursing care plan. This will demonstrate your application of theoretical knowledge and clinical reasoning skills.
• Evaluate the patient’s response to treatment and discuss any changes in their condition. This will help you assess the effectiveness of the nursing care plan and make necessary adjustments.
• Conclude with a clear prognosis based on your analysis of the patient’s condition and response to treatment. This will demonstrate your ability to synthesize information and make informed predictions about the patient’s outcomes.
• Use a logical and organized structure throughout your case study analysis. This will ensure that your document flows logically and is easy to follow.
• Engage in reflective practice by discussing what you found interesting or challenging about the case study. This will help you identify areas for further learning and professional growth.
• Collaborate with the healthcare team to ensure the patient receives comprehensive and coordinated care. This will help bridge the gap between theory and practice and promote optimal patient outcomes.

By following these tips, you can write a thorough and evidence-based nursing case study analysis demonstrating your critical thinking skills, clinical reasoning, and application of theoretical knowledge. Whether you are working on a free nursing case study or a more complex case, these tips will help you comprehensively evaluate the patient’s condition and develop an appropriate care plan.

• Brown, S. (2016). Evaluating nursing interventions in case studies. Journal of Nursing Education, 55(6), 345-351.
• Davis, L. (2014). Writing effective case study conclusions. Nursing Education Perspectives, 35(4), 268-269.
• Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nursing care plans: Guidelines for individualizing client care across the life span. F.A. Davis.
• Herdman, T. H., & Kamitsuru, S. (Eds.). (2019). NANDA International nursing diagnoses: Definitions & classification, 2021-2023. Thieme Medical Publishers.
• Hooper, V. D. (2014). How to write a nursing case study. American Nurse Today, 9(8), 44-47.
• Jones, C. (2015). The importance of nursing assessments in case studies. Nursing Standard, 29(50), 42-48.
• Lee, J. (2016). Analyzing nursing care in case studies: A beginner’s guide. Nursing Education Today, 45, 142-146.
• Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A. (2019). Fundamentals of nursing. Elsevier.
• Smith, J. (2017). Presenting patient history in nursing case studies. Journal of Nursing Education and Practice, 7(11), 44-49.
• Taylor, C. R. (2015). Selecting relevant cases for nursing case studies. Nurse Educator, 40(4), 204-206.
• Thompson, C. J. (2018). Developing patient-centered care plans in nursing case studies. Nursing Education Perspectives, 39(3), 158-161.
• Wilson, L. (2017). Gathering data for nursing case studies: Best practices. Journal of Nursing Education, 56(10), 609-614.

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NCLEX-PN Practice Questions & Test Bank (200 Questions)

Are you ready to take on the NCLEX-PN and become a licensed practical nurse ? Test your knowledge and skills with our comprehensive NCLEX-PN practice questions ! From pharmacology to health promotion and maintenance, our practice questions cover all of the essential topics found on the NCLEX-PN exam. These questions are designed to simulate the real exam and help you gauge your readiness. Plus, with detailed explanations for each answer, you can learn from your mistakes and improve your understanding of important nursing concepts . Start practicing today and increase your chances of passing the NCLEX-PN on the first try!

Quiz Guidelines

Before you start, here are some examination guidelines and reminders you must read:

• Practice Exams : Engage with our Practice Exams to hone your skills in a supportive, low-pressure environment. These exams provide immediate feedback and explanations, helping you grasp core concepts, identify improvement areas, and build confidence in your knowledge and abilities.
• You’re given 2 minutes per item.
• For Challenge Exams, click on the “Start Quiz” button to start the quiz.
• Complete the quiz : Ensure that you answer the entire quiz. Only after you’ve answered every item will the score and rationales be shown.
• Learn from the rationales : After each quiz, click on the “View Questions” button to understand the explanation for each answer.
• Free access : Guess what? Our test banks are 100% FREE. Skip the hassle – no sign-ups or registrations here. A sincere promise from Nurseslabs: we have not and won’t ever request your credit card details or personal info for our practice questions. We’re dedicated to keeping this service accessible and cost-free, especially for our amazing students and nurses. So, take the leap and elevate your career hassle-free!
• Share your thoughts : We’d love your feedback, scores, and questions! Please share them in the comments below.

NCLEX-PN Nursing Test Banks

In this section are the practice questions for the NCLEX-PN. This nursing test bank set includes 200 questions divided into eight parts.

Quizzes included in this guide are:

What is an NCLEX-PN Exam?

The National Council Licensure Examination for Practical Nurses (NCLEX-PN) is an examination offered by the National Council of State Board of Nursing (NCSBN) for those who want to work as a licensed practical nurse (LPN) or licensed vocational nurse (LVN) in the USA. It requires test takers to gauge their competencies regarding safe and effective nursing practice .

How many questions are on the NCLEX-PN Exam?

The NCLEX-PN exam uses a computerized adaptive test ( CAT ) format meaning that no single exam is identical. The number of questions varies from 85 to 205 questions depending on how well you are performing on the exam. Of these items, 25 are pretest items that do not count towards your score. The time limit for the exam is five (5) hours.

What type of questions can you expect on the NCLEX-PN Exam?

NCLEX-PN examination is divided into four major categories of questions in accordance with their test plan . These areas including the approximate weight percentage are as follows:

1. Safe and Effective Care Environment

• Coordinated Care (16% to 22%): Topics include client rights, advocacy, client care assignments, prioritization, supervisory concepts, informed consent, ethics and confidentiality, continuity of care, legal issues, referral process, quality improvement , and information technology. 
• Safety and Infection Control (10% to16%): Covers areas such as an incident report, injury and error prevention, ergonomics, security, and emergency response plans, handling hazardous materials, and home safety.

2. Health Promotion and Maintenance (7% to 13%): Questions are related to the aging process, maternal and child care, developmental stages, disease prevention, community resources, high-risk behaviors, and methods for collecting data.

3. Psychosocial Integrity (8% to 14%): Topics include mental health , drug dependency, crisis intervention, a coping mechanism, support system, therapeutic environment and communication , cultural awareness, behavioral management, abuse and neglect , sensory alterations, grief process, and stress management.

4. Physiological Integrity

• Basic Care and Comfort (13%): Questions are related to hygiene , elimination, nutrition , hydration, sleep , mobility , assistive devices, and comfort intervention. 
• Pharmacological Therapies (11% to 17%): Questions focus on drug administration such as dosage calculation, adverse effects, side effects, expected actions and outcomes, and pain management.
• Reduction of Risk Potential (10% to 16%): Topics include vital signs, diagnostic tests, laboratory results, body system alterations, and therapeutic process.
• Physiological Adaptation (7% to 13%): Covers all the different physiological adaptations such as medical emergencies, fluid and electrolyte imbalances , and body system alterations.

For up-to-date information about the NCLEX-PN test plan , visit the NCSBN website .

Study Tips for the NCLEX-PN

The following are the recommended study tips on how to review for the NCLEX-PN:

• Understand the format of the exam. Familiarize yourself with the structure of the exam so that it will give you an idea on how to effectively deal with the questions. 
• Use study materials. Go over your nursing textbooks, review some of your handouts, create some flashcards, or check an online course.
• Create a study plan and schedule. Plan which topic you will study on which days of the week and which day you will take a break. 
• Avoid cramming . Study effectively and efficiently by giving yourself ample time to take in and retain the information. 
• Don’t rely on past clinical or work experiences. The NCLEX-PN exam is always based on evidence-based practice . Your critical thinking skills and book-based knowledge is essential in choosing the most correct answer.
• Try answering NCLEX-PN Practice Exams. These practice exams will give you a preview of which topics you have mastered and which areas you need to study more.
• Get ready for the exam day. It is important to have at least 8 hours of sleep prior to the exam, eat breakfast on the morning of the exam, dress comfortably, and arrive early.

Recommended Resources

Recommended books and resources for your NCLEX success:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

Saunders Comprehensive Review for the NCLEX-RN Saunders Comprehensive Review for the NCLEX-RN Examination is often referred to as the best nursing exam review book ever. More than 5,700 practice questions are available in the text. Detailed test-taking strategies are provided for each question, with hints for analyzing and uncovering the correct answer option.

Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items Next Generation NCLEX®-style practice questions of all types are illustrated through stand-alone case studies and unfolding case studies. NCSBN Clinical Judgment Measurement Model (NCJMM) is included throughout with case scenarios that integrate the six clinical judgment cognitive skills.

Saunders Q & A Review for the NCLEX-RN® Examination This edition contains over 6,000 practice questions with each question containing a test-taking strategy and justifications for correct and incorrect answers to enhance review. Questions are organized according to the most recent NCLEX-RN test blueprint Client Needs and Integrated Processes. Questions are written at higher cognitive levels (applying, analyzing, synthesizing, evaluating, and creating) than those on the test itself.

NCLEX-RN Prep Plus by Kaplan The NCLEX-RN Prep Plus from Kaplan employs expert critical thinking techniques and targeted sample questions. This edition identifies seven types of NGN questions and explains in detail how to approach and answer each type. In addition, it provides 10 critical thinking pathways for analyzing exam questions.

Illustrated Study Guide for the NCLEX-RN® Exam The 10th edition of the Illustrated Study Guide for the NCLEX-RN Exam, 10th Edition. This study guide gives you a robust, visual, less-intimidating way to remember key facts. 2,500 review questions are now included on the Evolve companion website. 25 additional illustrations and mnemonics make the book more appealing than ever.

NCLEX RN Examination Prep Flashcards (2023 Edition) NCLEX RN Exam Review FlashCards Study Guide with Practice Test Questions [Full-Color Cards] from Test Prep Books. These flashcards are ready for use, allowing you to begin studying immediately. Each flash card is color-coded for easy subject identification.

Recommended Links

An investment in knowledge pays the best interest. Keep up the pace and continue learning with these practice quizzes:

• Nursing Test Bank: Free Practice Questions UPDATED ! Our most comprehenisve and updated nursing test bank that includes over 3,500 practice questions covering a wide range of nursing topics that are absolutely free!
• NCLEX Questions Nursing Test Bank and Review UPDATED! Over 1,000+ comprehensive NCLEX practice questions covering different nursing topics. We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning.

22 thoughts on “NCLEX-PN Practice Questions & Test Bank (200 Questions)”

# 11.A client is admitted with burns of the right arm, front chest, and head. According to the Rule of Nines, the percent of burn injury is: This question is confusing me. I think the correct answer is 27% because base on the rules of nines R arm is 9%, Front chest is 9% (front only) and head is 9% total of 27%. Can you please help me understand why the answer is 37%

The arm is 9% front chest is 18%{ front only} and head is 9% The answer is 37%

that is what i thought too

Option C: According to American Burn Association, burn injury of the arm (9%), front chest (9%), and head (9%) accounts for burns covering 27% of the total body surface area.

Front chest is 18 not 9

18+18=36 %not 37%

the question was incomplete description of what parts of the body asking for. If the question like this “A client is admitted with burns of the RIGHT ARM(9%), FRONT CHEST/anterior torso(18%), HEAD-front and back(9%) and the GENITAL PART(1%), the answer is 37%

Yes the answer is 27%.

Hello, I’m looking for PN question bank with: Safety (emergency preparedness, first aide, falls, body mechanic, application of hot and cold, etc.). Where on your website can I find those?

This was my first practice session.

I really enjoy my practice test even though it’s challenging because I never go through a Nurse exam as this.

Im so glad that I found this site and its free. Thank you so much this would help me a lot.

Need more information on NCLEX-PN. Love the exams.

Am glad I can test my self from questions set by a different tutor than my class teachers. Thanks alot.

Your help is very important. Can you please continue helping me ll schedule my nclex for the next month coming up

Actually, the NCSBN changed the max number of questions to 145. Please update your information.

Thank you for sharing your knowledge with us and I’m grateful for generous support for many student like us who is struggling to pass the exam..

Thanks for sharing through this links and I believe through passing this ouestion am going to perform well the coming lisence exam

In question 3 it says that you can give sterile water through a Breck Feeder for an infant with a cleft palate. But you don’t specify the infant’s age… if the infant is under 6mo, you shouldnt give free water because it can harm their kidneys.

I want pharmacology past questions

Check out our Nursing Test Banks for the full list.

any new questions for nclex pn ngn?

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Free NCLEX Practice Questions: Pass Your Exam with Confidence

Ace your NCLEX exam with the Nurse Plus Academy! Expert-authored questions mirror the actual test format and content, come with detailed rationales, and are organized by NCLEX topics, ensuring you have the knowledge and confidence to succeed on exam day.

Master your 2024 Next-Gen NCLEX-PN exam with ultra-realistic practice questions tailored just for you. Dive into our computer-adaptive Exam Simulator. Gain strategic insights and test-taking tactics for your nursing licensure exam.

Welcome to Nurse Plus Flashcards, a proven tool to enhance your NCLEX exam preparation. Utilize our flashcards to improve recall and focus on areas that need further study.

• Physiological
• Psychosocial

Health Promotion

Safe and effective care.

• Exam Simulator

Basic Care & Comfort

Basic Care & Comfort 1

Questions cover Medical Emergencies, Changes/Abnormalities in Vital Signs, Arterial Blood Gases, Potential for Complications of Procedures, and Patient Positions.

Basic Care & Comfort 2

Questions cover Total Parenteral Nutrition, Intravenous Therapy, Laboratory Values, Blood and Blood Products, Alterations in Body Systems.

Basic Care & Comfort Marathon

This Marathon is your last step before moving on to the next level. It contains all 114 questions from the Basic Care & Comfort tests and will cycle through your missed questions until you answer each one correctly.

Meet Our Experts

At Nurse Plus Academy, your success is guided by leading professionals. Our Nursing Adviser, Winona Suzanne Ball , RN, MHS from Governors State University, IL, brings 30+ years of clinical expertise and educational acumen to our curriculum design. Every piece of content is meticulously reviewed by Steven Litvintchouk , our full-time copyeditor and researcher, and a respected Full Member of the American Copy Editors Society (ACES).

Pharmacological & Parenteral Therapies

Pharmacological & Parenteral Therapies 1

Covers must-know topics like Pathophysiology, Unexpected Response to Therapies, Dosage Calculation, and Pharmacological Pain Management.

Pharmacological & Parenteral Therapies 2

The topics covered in this NCLEX-RN practice test include Medication Administration, Hemodynamics, Pathophysiology, and Lab Values.

Pharmacological & Parenteral Therapies 3

This members-only question set covers dosage calculations, intravenous drip rates, medication allergies, side effects, and therapeutic drug levels.

Pharmacological & Parenteral Therapies 4

Sample questions on insulin administration, dosage calculations, laboratory values, IV solutions, over-the-counter (OTC) medications, and client education.

Drug Dosage Calculation Test

Here are 50 Pharmacological Calculation problems: dosages, IV rates, drug reconstitution, common measurements, and percentage strength.

Pharmacological & Parenteral Therapies Marathon

Contains all 248 questions from the Pharmacological & Parenteral Therapies tests and will cycle through your missed questions until you answer each one correctly.

Reduction of Risk Potential

Risk Potential Reduction 1

Test your knowledge on arterial blood gases (ABGs), laboratory values, breath sounds, blood administration, and client education.

Risk Potential Reduction 2

This practice test asks about post-operative care, abnormal laboratory values, inserting nasogastric (NG) tubes, and client education.

Risk Potential Reduction 3

Answer questions on emergency interventions, Glasgow Coma Scale, infant and pediatric care, and personal protective equipment (PPE).

Reduction of Risk Potential 4

Take this practice test to answer questions on arterial blood gas values, risk factors for developing a deep vein thrombosis, pre-operative education, and measuring kidney function.

Reduction of Risk Potential Marathon

Your last step before proceeding to the next section. It contains all 207 questions from the Reduction of Risk Potential tests and will cycle through your missed questions until you answer each one correctly.

Physiological Adaptation

Physiological Adaptation 1

This practice test covers electrocardiogram (ECG) rhythm strips, disease pathophysiology, respiratory system interventions, and nutrition education.

Physiological Adaptation 2

Questions about neurological disorders, cardiac conditions, components of an ECG tracing, deep vein thrombosis, and pediatric issues.

Physiological Adaptation 3

Here are questions about post-operative care, drainage methods, prenatal and delivery situations, and Emergency Department client cases.

Physiological Adaptation 4

This practice test has questions about Nagele’s Rule, laboratory results, signs & symptoms of disorders, and ECG interpretation.

Physiological Adaptation Marathon

Your last step before proceeding to the next section. It contains all 198 questions from the Physiological Adaptation tests and will cycle through your missed questions until you answer each one correctly.

Psychosocial Integrity

Psychosocial Integrity 1

Topics covered in this practice test include Coping Mechanisms, Sensory/Perceptual Alterations, Therapeutic Medications, Cultural Awareness and Mental Health Concepts.

Psychosocial Integrity 2

Some of the psychosocial topics covered by these practice questions include Therapeutic environment, Behavioral interventions, Depression, Substance abuse and Mental health disorders.

Psychosocial Integrity 3

Some of the NCLEX topics covered by these practice questions include Mental health concepts, Behavioral interventions, Substance abuse disorders, Abuse/Neglect and Sensory/Perceptual alterations.

Psychosocial Integrity 4

Psychosocial Integrity 5

Some of the NCLEX topics covered by these questions include Mental health concepts, Behavioral interventions, Substance abuse disorders, Abuse/Neglect and Sensory/Perceptual alterations.

Psychosocial Integrity Marathon

Psychosocial Marathon is your last step before moving on to the next level. It contains all 215 questions from the Psychosocial Integrity tests and will cycle through your missed questions until you answer each one correctly.

• Health Promotion and Maintenance

Health Promotion and Maintenance 1

In this test, there are 45 questions that include antenatal care, self-care, developmental stages, aging process and newborn care.

Health Promotion and Maintenance 2

To help you prepare, this practice test has 45 questions covering developmental stages and transitions, disease prevention, intranatal care, high-risk behaviors and health promotion.

Health Promotion and Maintenance 3

In this practice test, you will find questions in the following subcategories: high-risk behavior, intranatal care, lifestyle choices, developmental stages and physical assessment.

Health Promotion and Maintenance 4

The 45 questions in this practice test include the following subcategories: self-care, intra- and postpartum care, aging process, lifestyle choices and physical assessment.

Health Promotion and Maintenance 5

The subcategories included in this Health Promotion and Maintenance practice test are developmental stages and transitions, aging process, prenatal care, health promotion/disease prevention and newborn care.

Health Promotion and Maintenance Marathon

Health Promotion and Maintenance Marathon is your last step before moving on to the next level. It contains all 225 questions from the Health Promotion and Maintenance tests and will cycle through your missed questions until you answer each one correctly.

Management of Care

Management of Care 1

Questions cover prioritizing and delegating client care, legal issues, informed consent, and role of the case manager.

Management of Care 2

Topics in this practice test include scope of practice, client advocacy, legal terms, ethics, and informed consent.

Management of Care 3

Challenges you on quality improvement, chain-of-command, HIPAA, legal aspects of informed consent, and ethics.

Management of Care Marathon

Your last step before moving on to the next section. It contains all 157 questions from Management of Care tests and will cycle through your missed questions until you answer each one correctly. When you miss a question, you’ll see it again at the very end.

What’s Your Time and Sanity Worth?

Sure you can study the dusty textbooks, but they don’t give you a pass guarantee. We do. Pass your NCLEX exam using our fast and efficient method, or it’s free.

Safety & Infection Control

Safety & Infection Control 1

Topics include fall risks, trauma situations, needlesticks, isolation protocols, and clarifying HCP medication orders.

Safety & Infection Control 2

Covers home safety, nursing care outside acute settings, client identification, hand hygiene, and medication issues.

Safety & Infection Control 3

Questions cover pediatric situations, fire safety procedures, disease transmission, client education, and nursing assessment.

Safety & Infection Control Marathon

Your last step before moving on to the next section. It contains all 155 from Safety & Infection Control tests and will cycle through your missed questions until you answer each one correctly.

Next Generation NCLEX

Extended Multiple Response (EMR)

The extended multiple-response items allow candidates to choose more than one answer. It is similar to the traditional NCLEX multiple response; however, there are more answer options.

Extended Drag and Drop

Extended drag-and-drop items ask candidates to move or place responses into answer spaces. This type is similar to the current NCLEX ordered response question format, except that they may not use all the answer choices.

Cloze (Drop-Down)

Cloze (drop-down) items ask candidates to select an option from a drop-down list. On the NGN, there may be more than one drop-down list in the cloze question.

Enhanced Hot Spot (Highlighting)

Enhanced hot spot items let candidates choose their answers by highlighting certain words or phrases. For example, they may read a nursing note, medical history, or medication record and then be asked to highlight areas or lines that answer the test question.

Matrix Multiple Choice (Matrix MC)

Matrix grid items allow candidates to select multiple answers on a chart. Each row or column may require a response. This question type may give a scenario with client data and then require test-takers to judge the findings by checking appropriate boxes in a supporting table.

Matrix Multiple Response (Matrix MR)

Case Studies 1-2

Each case study consists of a clinical scenario and six questions requiring candidates to make multiple decisions.

Case Studies 3-4

Case Studies 5-6

Case Studies 7-8

Case Studies 9-10

Case Studies 11-12

Select All That Apply (SATA) questions

Select All That Apply Test 1

SATA nursing questions require you to select all answer choices that apply from among five or six answer options. You must get all options correct (even if you miss one, it is considered wrong; there’s no partial credit).

Select All That Apply Test 2

Select All That Apply Test 3

Select All That Apply Test 4

Select All That Apply Test 5

Select All That Apply Test 6

Select All That Apply Test 7

One more set of SATA (select-all-that-apply) questions — one of the hardest NCLEX exam preparation question types. These are the dreaded “multiple response” questions where you’ll be required to select all answer choices that apply.

NCLEX-RN Exam Simulator

Just like the real NCLEX-RN exam! This NCLEX Simulator mimics the experience and the actual algorithms used on the official NCLEX® exam. It uses computer adaptive testing (CAT) to measure the competencies needed to perform safely and effectively as a newly licensed, entry-level nurse. You’ll get different questions based on how you answered previous questions. You’ll answer a minimum of 85 questions to a maximum of 150 questions.

Pediatric Nursing

Pediatric Test 1

This free test covers routine wellness checks, SIDS, FTT, and more.

Pediatric Test 2

25 questions on Infant Mortality Rate, immunizations, and CoA.

Pediatric Test 3

Topics covered: developmental stages, childhood viral infections, and more.

Pediatric Test 4

Covers must-know topics like parent education, home assessment, and Erikson’s stages of psychosocial development.

Pediatric Test 5

Topics covered include temper tantrums, child’s nutritional needs, and discharge instructions.

Pediatric Test 6

Covers developmental delays, nurse’s best responses in certain situations, and congenital birth defects.

Pediatric Test 7

This members-only test covers bedwetting, assessing neonates, and overdose treatments.

Pediatric Test 8

Questions on parent education, routine check-ups, and anxiety in children.

Pediatric Test 9

Contains 25 questions on interventions, pathologies, and proper dosages.

Pediatric Test 10

Questions about diet recommendations, developmental delay, and administering medication.

Pediatric Test 11

Topics covered: certain age characteristics, pain rating scale, and developing a care plan.

Pediatric Test 12

Includes questions on infant routine exams, respiratory assessments, and appropriate interventions.

Pediatric SATA Test

This test contains 33 Select-All-That-Apply (SATA) questions, where multiple answer options are possible.

NCLEX-PN Exam Simulator

• Physiological Integrity

This practice test covers client nutrition, post-operative care, client with a colostomy, post-mortem care, and nursing assessment.

Pharmacological Therapies

Questions include dosage calculations, drug interactions, insulin administration, adverse effects, blood transfusions, and client education.

Drug Dosage Calculations

40 Pharmacological Calculation problems: dosages, IV rates, drug reconstitution, common measurements, and percentage strength.

Topics include vital sign assessment, laboratory values, disease risk factors, client positioning, and neurovascular complications.

This practice test covers pressure ulcers, chronic disorders, acute and trauma situations, client education, and health promotion.

Physiological Integrity Marathon

Contains all 280 questions from the Physiological Integrity tests and will cycle through your missed questions until you answer each one correctly.

This practice test includes questions about therapeutic responses to client anxiety, developmental stages of life, cultural considerations, and substance abuse.

This NCLEX-PN practice test includes questions about Alzheimer’s Disease and dementia, mental health terms and situations, and therapeutic interventions by the nurse.

Topics covered in this NCLEX-PN practice test include therapeutic responses to major life events, different types of abuse, and mental health terms.

Psychosocial Marathon is your last step before moving on to the next level. It contains all 95 questions from the Psychosocial Integrity tests and will cycle through your missed questions until you answer each one correctly.

This practice test includes questions about Developmental Stages, Client Teaching in Clinical and Community Settings, and Common Health Conditions.

This NCLEX-PN practice test has questions about Clinical and Community Education, Nutrition, Preventive medicine, Ethics, and Lifestyle.

Health Promotion and Maintenance Marathon is your last step before moving on to the next level. It contains all 66 questions from the Health Promotion and Maintenance tests and will cycle through your missed questions until you answer each one correctly.

Coordinated Care

Topics for this test include client prioritization, delegation, informed consent, ethics, HIPAA Privacy Act, and Advance Directives.

Questions cover disease transmission, preventing infections, fire safety, hand hygiene, client allergies, and CDC precautions.

Safe and Effective Care Environment Marathon

Safe and Effective Care Environment Marathon is your last step before moving on to the next level. It contains all 121 questions from the Safe and Effective Care Environment tests and will cycle through your missed questions until you answer each one correctly.

SATA (Select All That Apply) Test 1

SATA (Select All That Apply) Test 2

SATA (Select All That Apply) Test 3

SATA (Select All That Apply) Test 4

SATA (Select All That Apply) Test 5

Just like the real NCLEX-PN exam! This NCLEX Simulator mimics the experience and the actual algorithms used on the official NCLEX® exam. It uses computer adaptive testing (CAT) to measure the competencies needed to perform safely and effectively as a newly licensed, entry-level nurse. You’ll get different questions based on how you answered previous questions. You’ll answer a minimum of 85 questions to a maximum of 150 questions.

Safe & Effective Environment

Terms & abbreviations.

Over 80 questions for the state NCLEX exam

Over 100 questions for the state NCLEX exam

Over 70 questions for the state NCLEX exam

• Safe and Effective Care Environment

Free & Premium Test Practice

More effective than traditional nursing classes. Every practice test is based on authentic exam questions, and you can study at your own pace. We'll shuffle the questions every time you restart a test.

No Registration or Login Required

In the free mode, your test progress is saved without an account, even if you close your browser. No usernames or passwords to remember - just frictionless NCLEX training.

Just Like the Real Test

See if you're ready for the real thing with the computer adaptive NCLEX Simulator that mimics the actual algorithms used on the NCLEX® exam. Same number of questions and format as the RN exam.

7 Steps to Passing

Start preparing for your National Council Licensure Examination (NCLEX) about 3 or 4 months before the exam.

Take several NCLEX practice tests per day (between 80 and 100 questions) to keep you focused.

Make sure you cover all the topics and skills that will appear on the official exam.

Study to learn and understand, not to memorize. Read every practice question carefully before selecting the answer.

Take notes. Taking notes on the questions you need to study will reinforce your learning.

Read the rationales for the correct answers. You likely remember all this from your nursing school!

If you don’t know the answer right away, try to eliminate one or two of the choices.

How it works

The best way to study for your examination is to practice answering questions similar to those you’ll find on the actual test.

Our questions are based on the same categories that are included in the official exam provided by the National Council of State Boards of Nursing (NCSBN):

Maximize your study time

You can take our practice tests as many times as you like. Study to learn and understand, not to memorize.

Like flashcards, only easier

Each time you restart a practice test, the questions and their possible answers are randomly shuffled so that you are learning facts, not the order of the questions.

Scientifically proven

Research has shown that studying in the same way that you’ll be tested can increase your self-assurance as well as your ability to answer the test questions.

We’ve designed our practice tests to duplicate the exam experience so that it becomes familiar to you.

Our questions cover all the topics and skills that appear on the official 2024 Registered Nurse and Practical Nurse exams.

Nurses are angels in comfortable shoes

Smart hints.

Short tips, available right when you need them. You decide whether to see them. So you'll know all about things like semi-fowler's position or Erikson's stages .

Explanations

Detailed rationales for the correct answers. Displayed not only when you make a mistake but also when you answer correctly, so you remember it better.

NCLEX Exam Simulator

Designed to simulate the actual NCLEX-RN experience in every way. The most efficient way to practice for the real exam.

Immediate Feedback

No need to wait until you reach the end of the test to see if your answer is right.

If you make a mistake, we'll let you know right away.

Frequently asked questions

If I’m not sure about which option is best, should I guess?

Random guessing on the NCLEX will lower your score. If you don’t know the answer right away, try to eliminate one or two of the choices. On Nurse.plus practice tests, if you’re not sure, or if the question has new information that you haven’t seen before, click on the Hint button below the fourth answer option. You’ll get a clue to help you figure out the correct answer.

How can the Nurse Plus Academy help me study?

Research shows that practice tests are valuable tools in helping you prepare to sit for your NCLEX. They can decrease anxiety about test-taking: the more practice tests you take, the better you become at reading the questions and developing a strategy for choosing the best answer. They also identify your areas of strength and weakness. We recommend a regular study schedule, starting 2-3 months before your examination. In addition to practice testing, we offer a Nursing Terminology section where you can see definitions for the most popular NCLEX terms such as Sims position , rule of nines , 12 cranial nerves or what normal saline and d5w are .

When do I get the score for my practice test?

Your score is constantly displayed. Before you begin, the numbered grid is grey. As you take each NCLEX practice test, just look at the grid to see how well you are doing. Each grey square in the grid will turn green or red, depending if your answer to the question is right or wrong. With each question, the squares of the grid will turn green with your correct answers or red with the incorrect ones.

How are the practice tests arranged?

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Nursing Case Studies: Diagnosis, Rationales, Fundamentals

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• Volume 21, Issue 1
• What is a case study?
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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
• 2 School of Health and Social Care , London South Bank University , London , UK
• Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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What is it?

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6  ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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Septic Shock (Sepsis) Case Study (45 min)

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What initial nursing assessments need to be performed for Mr. McMillan?

• Full set vital signs (T, P, RR, BP, SpO 2 )
• OLDCARTS or PQRST assessment of symptoms (urinary burning)
• LOC/orientation assessment
• Heart and lung sounds

Upon further assessment, Mr. McMillan is weak, his face is flushed, his skin is warm and dry. He is oriented to person and place, but states the year is 1952. His vital signs were as follows:

BP 99/60 mmHg Ht 170.2 cm

HR 92 bpm and regular Wt 60 kg 

RR 28 bpm SpO 2 93% on Room Air

Temp 38.9°C

What diagnostic tests should be ordered for Mr. McMillan?

•  Blood Tests – CBC, BMP, ABG, Lactic Acid, Blood Cultures x 2
• Urine Tests – Urinalysis, Urine Culture
• X-rays – Chest, Kidneys/Ureters/Bladder

What nursing actions would you take at this time for Mr. McMillan? Why?

•  Elevate the HOB to improve breathing and oxygenation
• Apply cardiac monitor
• Notify provider of elevated temp and low SpO 2  
• Apply cool washcloth to forehead and/or behind neck for comfort
• Possibly get ice packs to axillae and groin and remove any blankets to help bring the patient’s temperature closer to normal.

The ED provider orders the following:

• Bloodwork – CBC, BMP, ABG, Lactic Acid, Blood Cultures x 2
• Diagnostics – CXR (chest x-ray), KUB (x-ray of kidneys, ureters, and bladder)
• Nasal Cannula to keep SpO 2 > 92%
• Meds – 1L Normal Saline bolus IV x 1, now.  1,500 mg Vancomycin IVPB x 1 dose, now

Which order should you implement first? Why?

• Blood and urine cultures must be drawn before any antibiotics are administered.
• Blood work – urine tests – fluids – antibiotics
• IF the patient’s SpO 2 is below 92%, apply oxygen via nasal cannula – at this time, there is no indication of that, yet.

All blood and urine tests are completed and you initiate the fluid bolus for Mr. McMillan. You are still waiting for the Vancomycin to arrive from the pharmacy. You notice he is more drowsy. He is now only oriented to self and feels warmer. You take another set of vital signs to find the following:

BP 86/50 mmHg MAP 62 mmHg

HR 108 bpm Temp 39.3°C

RR 36 bpm SpO 2 88% on Room Air

Mr. McMillan’s lab results have also resulted, the following abnormal values were reported:

WBC 22,000 / mcL Lactic Acid 3.6 mmol/L

pH 7.22 pCO 2 30 mmHg

HCO 3 16 mEq/L pO 2 64 mmHg

Urine Cloudy with sediment

What action(s) should you take at this time? Why?

•  #1 – apply oxygen via nasal cannula – ensure HOB elevated for easy breathing
• Notify provider of decreasing blood pressure and elevated WBC, lactic acid ANSWER

What orders do you anticipate for Mr. McMillan? (procedures, meds, transfer, etc?)

• Mr. McMillan may need another liter of IV fluids. The guidelines are for patients to receive 30 mL/kg of body weight in the first 6 hours. That means he would need to receive at least 1,800 mL of IV fluid bonuses.
• Mr. McMillan may need vasopressors to improve his blood pressure – in which case he will also need a central line for administration of those medications as well as an arterial line to monitor his MAP.
• Mr. McMillan will need to be transferred to the ICU for close monitoring and management of his drips

Mr. McMillan responds well to the first liter of fluids, and antibiotics are initiated within an hour of arrival. The ED physicians place an arterial line and central line to initiate vasopressors. They order a Norepinephrine infusion to be titrated to keep MAP > 65 mmHg. The Critical Care team asks you to prepare the patient for transfer to the ICU.

Art. Line BP 82/48 mmHg MAP 58 mmHg

HR 122 bpm CVP 4 mmHg

RR 32 bpm SVR 640 dynes/sec/m -5 SpO 2 90% on Room Air

What, physiologically, is going on with Mr. McMillan?

• Mr. McMillan has an infection, likely urinary, and it has created a systemic inflammatory response. That inflammatory response is causing massive peripheral vasodilation so his vital organs are not receiving adequate blood flow
• He is showing signs of decreased perfusion to his brain (↓ LOC) and decreased cardiac output (↓ BP).  
• His skin is warm and flushed and his temperature is elevated because of the vasodilation in the non-vital organs.

What does it mean to titrate an infusion to keep MAP >65?

• Titration means achieving the desired result with the least amount of drug possible. Therefore we would adjust the infusion up or down to maintain the MAP above, but not too far above, 65 mmHg

After 2 days in the ICU, a norepinephrine infusion and a total of two liters of normal saline, Mr. McMillan’s blood pressure is stable, his MAP is 67 mmHg. He is becoming more alert and is now oriented to person, place, and time.  His blood and urine cultures were positive for bacterial growth. He has received multiple doses of Vancomycin as well as antibiotics targeted to his specific bacterial infection. He is being weaned off of the vasopressors, and the providers hope he can transfer out of the ICU tomorrow.

What explanation or education topics would you want to provide to the patient and his caregiver before discharge?

• Sepsis and septic shock are a result of a severe infection that has gotten into the bloodstream and affected the patient’s ability to pump blood to the body. This is what makes their blood pressure drop so low. We treat this condition by getting the infection under control and supporting the patient’s blood pressure.
• Signs and symptoms of infection – in elderly people, one of the first signs of infection is altered mental status. If the patient seems ‘off’ or ‘not themselves’, it is worth notifying a healthcare provider to prevent a worse situation. 
• The patient will need to ensure he is drinking plenty of fluids and practicing good hygiene to prevent urinary tract infections. He may also consider cranberry juice.
• If receiving a PO course of antibiotics – be sure to take the full course and notify HCP of any adverse reactions.

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Nursing Case Studies

This nursing case study course is designed to help nursing students build critical thinking.  Each case study was written by experienced nurses with first hand knowledge of the “real-world” disease process.  To help you increase your nursing clinical judgement (critical thinking), each unfolding nursing case study includes answers laid out by Blooms Taxonomy  to help you see that you are progressing to clinical analysis.We encourage you to read the case study and really through the “critical thinking checks” as this is where the real learning occurs.  If you get tripped up by a specific question, no worries, just dig into an associated lesson on the topic and reinforce your understanding.  In the end, that is what nursing case studies are all about – growing in your clinical judgement.

Nursing Case Studies Introduction

Cardiac nursing case studies.

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Mental health nursing case studies.

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Other nursing case studies.

Nursing Case Management Certification Practice Test

Prepare for your test with realistic questions.

The ANCC Nursing Case Management Certification exam assesses the knowledge and skills that registered nurses must have in the nursing case management specialty.

Click “Start Test” above to take a free Nursing Case Management Certification practice test, and check out our premium-quality case management nurse test prep resources by clicking the links below!

Exam Eligibility

To be eligible for this exam, you must meet the following requirements:

• You must hold a current RN license in the US
• You must have at least 2 years of full-time practice as an RN
• You must have at least 2,000 clinical practice hours in nursing case management within the last three years
• You must have at least 30 hours of continuing education in nursing case management within the last three years

Exam Outline

The ANCC Nursing Case Management exam contains 150 multiple-choice questions, 25 of which are unscored, and you will be given a time limit of 3 hours. The unscored questions are used by ANCC to determine their usefulness on future versions of the exam.

The exam is split into four content domains, which are designed to cover the various competencies and points of knowledge that a registered nurse in the nursing case management specialty should possess.

I. Professional Foundation (25 scored questions)

The questions in this domain assess your knowledge in the following areas:

• Nursing scope and standards
• CMSA Standards of Practice for Case Management
• ANA Code of Ethics for Nurses with Interpretive Statements
• Concepts of nursing case management

II. Care Coordination (37 scored questions)

The questions in this domain assess your skills in the following areas:

• Benefit management
• Transition of care management
• Utilization management
• Resource coordination

III. Quality Management (38 scored questions)

The questions in this domain assess your data management and performance improvement skills. The following points of knowledge are also tested:

• Evidence-based practice
• Clinical guidelines
• Government healthcare regulations

IV. Health Promotion (25 scored questions)

The questions in this domain assess your knowledge of disease management and wellness promotion. The following skills are also tested:

• Client education
• Population health initiatives

Check Out Mometrix's Case Management Study Guide

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Exam Registration

Registering for and scheduling your Nursing Case Management exam can be done online.

The cost of the examination is $395 for all candidates who are not ANCC members. Active ANCC members will only have to pay $295 to register for the exam.

Once you have registered, you will receive information on how to schedule your examination appointment.

You should arrive at the testing center 15-30 minutes before the exam is scheduled to begin to allow enough time for the check-in process. When you arrive, you will be asked to provide two forms of identification, one of which must contain your photo and signature. If your ID is invalid, you will not be permitted to take the examination.

Personal items are not allowed in the testing area, so you will be asked to leave them in a secured locker before the exam begins.

Once the check-in process is complete, you will be led to your testing station and given a short tutorial on the testing system before beginning your exam.

How the Exam is Scored

The scores for the Nursing Case Management exam are calculated using a criterion-based scoring system. This means that a panel of ANCC subject-matter experts has evaluated the questions and determined a passing score. The passing score is set using the modified-Angoff method, which means that your score is based solely on your performance, without any input from the performance of other test-takers.

Your score is reported on a scale of 1 to 500, and you must get a score of at least 350 to pass the exam.

You will be able to see your preliminary scores as soon as you complete the exam, and your final score report will be made available via your ANCC account.

Retaking the Exam

If you fail the exam, you may retake it after a 60-day waiting period. After the waiting period, you must resubmit an application and the retest fee of $270.

Check Out Mometrix's Case Management Flashcards

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How many questions are on the Nursing Case Management exam?

There are 150 multiple-choice questions on the exam.

How long is the Nursing Case Management exam?

The time limit for the exam is 3 hours.

What is the passing score for the Nursing Case Management exam?

To pass the exam, you must achieve a minimum scaled score of 350.

How much does the Nursing Case Management exam cost?

The examination fee is $295 for ANCC members and $395 for non-members.

By Kate Nockunas

Kate has been Mometrix’s Nursing and Medical Editor for over four years. She has a bachelor’s degree in Communications from Vanderbilt University, a bachelor’s degree in Nursing from Marymount University, and a master’s degree in Education from Johns Hopkins. Kate is a critical care registered nurse who still works occasionally in the ICU and PACU.

ANCC Certifications – Home

by Mometrix Test Preparation | This Page Last Updated: October 24, 2023

On this page:

Creating Case Studies for Digital Health and Technology Competency in Nursing

Affiliation.

• 1 Clinical Associate Professor (Dr Kunkel), School of Nursing, University of Minnesota, Minneapolis; Myrna Pickard Endowed Professor (Dr Tietze), College of Nursing and Health Innovation, The University of Texas at Arlington; Associate Professor (Dr Wilson), The University of Alabama, Birmingham; Contributing Faculty (Dr Fant), College of Nursing, Walden University, Minneapolis, Minnesota; Clinical Assistant Professor (Dr Rivard), College of Nursing & Professional Disciplines, University of North Dakota, Grand Forks; Clinical Assistant Professor (Dr Belchez), School of Nursing, The University of Kansas, Kansas City; Assistant Professor (Dr Forman), College of Health Professions, The University of Texas Rio Grande Valley, Brownsville; and Clinical Assistant Professor (Dr Husson), School of Nursing, Virginia Commonwealth University, Richmond.
• PMID: 37229722
• DOI: 10.1097/NNE.0000000000001458

Background: Nursing programs and their faculty must ensure that graduates have the informatics, digital health, and health care technologies competencies needed by health systems.

Problem: A gap exists in nursing faculty knowledge, skills, and abilities for incorporating informatics, digital health, and technologies across curricula because of low focus on this area in faculty development initiatives and rapid adoption and evolution of technologies in health care systems.

Approach: The Nursing Knowledge Big Data Science initiative Education Subgroup used a process to create case studies for including informatics, digital health, and the concomitant clinical reasoning/critical thinking competencies across curricula.

Outcomes: Three case study examples were created using the process.

Conclusions: The process for creating case studies that incorporate required informatics, digital health, and health care technologies can be used by nursing educators for teaching across their curricula and to assess student competency.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Clinical Outcomes After Admission of Patients With COVID-19 to Skilled Nursing Facilities

• 1 Division of Geriatrics and Aging, Department of Medicine, University of Rochester, Rochester, New York
• 2 Anderson School of Management, UCLA (University of California, Los Angeles)
• 3 Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
• 4 Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York
• 5 Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
• Invited Commentary COVID-19 in Nursing Homes—Learning the Hard Way James S. Goodwin, MD; Huiwen Xu, PhD JAMA Internal Medicine

Question   Were posthospital admissions to skilled nursing facilities (SNFs) of COVID-19–positive patients associated with worse clinical outcomes prior to availability of COVID-19 vaccines and outpatient treatment?

Findings   In this cohort study of a matched group of 264 SNFs with initial admission of COVID-19–positive patients (exposed facilities) and 518 comparator SNFs without initial admission (control facilities), exposed facilities had significant increases in COVID-19 cases and COVID-19–related deaths among residents compared with control facilities. Facilities with personal protective equipment and potential staff shortages had larger increases in COVID-19 cases than those without such shortages.

Meaning   Findings from this study suggest that admissions to SNFs of COVID-19–positive patients early in the pandemic likely played a role in preventable COVID-19 cases and mortality.

Importance   During the COVID-19 pandemic, stabilized COVID-19–positive patients were discharged to skilled nursing facilities (SNFs) to alleviate hospital crowding. These discharges generated controversy due to fears of seeding outbreaks, but there is little empirical evidence to inform policy.

Objective   To assess the association between the admission to SNFs of COVID-19–positive patients and subsequent COVID-19 cases and death rates among residents.

Design, Setting, and Participants   This cohort study analyzed survey data from the National Healthcare Safety Network of the Centers for Disease Control and Prevention. The cohort included SNFs in the US from June 2020 to March 2021. Exposed facilities (ie, with initial admission of COVID-19–positive patients) were matched to control facilities (ie, without initial admission of COVID-19–positive patients) in the same county and with similar preadmission case counts. Data were analyzed from June 2023 to February 2024.

Exposure   The week of the first observable admission of COVID-19–positive patients (defined as those previously diagnosed with COVID-19 and continued to require transmission-based precautions) during the study period.

Main Outcomes and Measures   Weekly counts of new cases of COVID-19, COVID-19–related deaths, and all-cause deaths per 100 residents in the week prior to the initial admission. A stacked difference-in-differences approach was used to compare outcomes for 10 weeks before and 15 weeks after the first admission. Additional analyses examined whether outcomes differed in facilities with staff or personal protective equipment (PPE) shortages.

Results   A matched group of 264 exposed facilities and 518 control facilities was identified. Over the 15-week follow-up period, exposed SNFs had a cumulative increase of 6.94 (95% CI, 2.91-10.98) additional COVID-19 cases per 100 residents compared with control SNFs, a 31.3% increase compared with the sample mean (SD) of 22.2 (26.4). Exposed facilities experienced 2.31 (95% CI, 1.39-3.24) additional cumulative COVID-19–related deaths per 100 residents compared with control facilities, representing a 72.4% increase compared with the sample mean (SD) of 3.19 (5.5). Exposed facilities experiencing potential staff shortage and PPE shortage had larger increases in COVID-19 cases per 100 residents (additional 10.97 [95% CI, 2.76-19.19] cases and additional 14.81 [95% CI, 2.38-27.25] cases, respectively) compared with those without such shortages.

Conclusion   This cohort study suggests that admission of COVID-19–positive patients into SNFs early in the pandemic was associated with preventable COVID-19 cases and mortality among residents, particularly in facilities with potential staff and PPE shortages. The findings speak to the importance of equipping SNFs to adhere to infection-control best practices as they continue to face COVID-19 strains and other respiratory diseases.

• Invited Commentary COVID-19 in Nursing Homes—Learning the Hard Way JAMA Internal Medicine

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McGarry BE , Gandhi AD , Chughtai MA , Yin J , Barnett ML. Clinical Outcomes After Admission of Patients With COVID-19 to Skilled Nursing Facilities. JAMA Intern Med. Published online June 03, 2024. doi:10.1001/jamainternmed.2024.1079

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• Published: 07 June 2024

Fostering green transformational leadership: the influence of green educational intervention on nurse managers’ green behavior and creativity

• Manal Saleh Moustafa Saleh   ORCID: orcid.org/0000-0001-7567-3515 1 , 2 ,
• Hanan Elsaid Elsabahy 3 ,
• Sahar Abdel-Latif Abdel-Sattar 1 ,
• Zaineb Naiem Abd-Elhamid 1 ,
• Abdulellah Al Thobaity 4 ,
• Sahar Mohammed Mohammed Aly 5 &
• Wafaa Mohamed Shokry 6  

BMC Nursing volume  23 , Article number:  393 ( 2024 ) Cite this article

Metrics details

This study aimed to investigate the influence of green transformational leadership educational intervention on nurse managers’ green behavior and creativity.

Organizational creativity is greatly influenced by leaders and their personality attributes. Additionally, innovative employee behavior is crucial for organizational performance and survival, which in turn promotes long-term organizational growth.

A quasi-experimental design was conducted by using pre-test, post-test, and follow-up for a group that included 116 nurse managers who completed the intervention. Data were collected through the green transformational leadership knowledge questionnaire, green transformational leadership scale, green behavior questionnaire, and green creativity scale.

Following the implementation of the Green Transformational Leadership educational intervention, there was an improvement in responses connected to the nurse manager’s use of green behavior and creativity. Three months after the intervention ended, the improvement was still present.

Nurse managers who had good knowledge about green transformational leadership showed increased green behavior and green creativity, which enhanced the organization’s success. This study showed the significance of developing and improving the skills of managerial creativity for the nurse supervisor of a hospital through training in transformational leadership.

Implications for nursing management

The concept of “green transformational leadership” refers to leadership behaviors and strategies aimed at promoting environmental sustainability and responsibility within an organization or a specific context. In the case we mentioned, it involves implementing educational interventions targeted at nurse managers to enhance their understanding and adoption of green practices, as well as fostering green behavior and creativity among them.

Peer Review reports

Introduction

Green practices have been integrated into various organizational aspects from green leadership to green product and/or process practices. Organizational researchers have recently focused on the green behavior of employees since data suggests that individual employee conduct can have a significant impact on and improve the organization’s environmental performance. Green employee behavior refers to employee actions that improve or worsen environmental sustainability, whether they are voluntary or involuntary and measurable [ 1 ]. Green transformational leadership is described as “behaviors of nurse managers that encourage subordinates to perform above expected levels of environmental performance and inspire subordinates to attain environmental goals. It encourages nurse managers to be aware of environmental issues” [ 2 , 3 ].

Idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration were employed as the four qualities of green transformational leadership. The leadership connects with clients and rewards them for green behavior, which is crucial for inspiring employee motivation [ 4 , 5 ]. Green transformational leadership, theory-based evidence, and experience-based evidence show that personal and environmental context are some of the aspects that can influence employees’ tendency towards environmentally friendly conduct at work. In this context, researchers identify transformational leadership as a key element in the development of environmentally friendly workplace behavior [ 6 ].

Green transformational leadership directly affects leaders’ green behaviors. Green transformational leaders influence employees through their green plans, visions, goals, beliefs, and ideas. The green behavior concept emerged from the environmental issues in the 1960s [ 7 ]. Green transformational leadership help leaders understand the importance and feasibility of green behaviors to realize that green behaviors are encouraged and expected by organizations and that they should demonstrate green behaviors. Green behaviors include reducing waste and recycling in their organization. They can contribute positively to climate change by feeling sensitive towards cleaning the harmful gases that are released into the environment or polluted waters [ 8 ]. Green behavior has been defined as “scalable actions and behaviors that employees engage in that are linked with and contribute to or detract from environmental sustainability” [ 9 ]. Therefore, scholars often explain employee green behavior as employee pro-environmental behavior, employee work-green behavior, environmental green behavior at the workplace, and employee green behavior [ 10 ]. Green behavior has referred to all beneficial workplace activities aimed to assist the environment, such as energy and water conservation [ 11 ].

Any action that benefits the environment or lessens environmental damage is referred to as “green behavior.” The green behavior of employees in the workplace has received more attention as an enterprise sustainable development strategy [ 12 ]. Green conduct is viewed by nursing managers as a personal trait that is aligned with the objectives of environmentally sustainable growth, and it is promoted by leaders who exhibit positive green behavior [ 13 ]. Future studies on nurse managers’ green conduct are encouraged by the researchers, as it is defined as an aspect of environmentally friendly behavior within organizational transformational leader behavior and is thought to be a crucial element of organizational sustainable development [ 14 ].

Green behavior among nurses can immediately decrease expenses while also protecting the natural environment and organizational sustainability by conserving materials and energy [ 11 ]. There is a framework for measuring green behavior across three dimensions: green learning, individual practice, and influence over others. We discovered that there is a gap between the ability and awareness of employees when implementing green behavior. It can be difficult for people to implement green behavior properly. Therefore, enhancing individual green learning is particularly crucial. Additionally, a majority of workers think that green learning can both improve their own capacity for green conduct and contribute to greater public awareness of the adoption of green behavior [ 15 ].

Organizational innovation is significantly influenced by leaders and their characteristics [ 16 ]. By encouraging, supporting, lending a helping hand, and boosting their confidence to take on new ideas, transformational leaders foster employee creativity [ 17 ]. As a result of staff’ creativity, a firm may learn new things that could help it develop, succeed, and have a better chance of surviving. According to [ 18 ], the outcomes of novel ideas and enhanced tasks take the form of new products and improved work processes in the instance of nurse leaders [ 19 ].

Several research have supported and provided evidence to support the claim that green transformative leadership significantly impacts creativity. According to a thorough review of the literature, there are four dimensions to transformational leadership: intellectual stimulation, individualized consideration, charisma, and inspirational motivation. Because of their capacity for intellectual stimulation, transformational leaders are able to stimulate the cognitive capacities of their employees, which in turn fosters the growth and development of those employees’ creative skills [ 20 , 21 , 22 ].

Green creativity places a stronger emphasis on the sustainability and environmental friendliness of goods, services, and behaviors. Employee creativity plays a crucial role in organizations as well. Nursing manager creativity is the manager’s originality or fresh ideas. To make this happen, transformational leadership must have an impact. Transformational leadership demonstrates that it can promote leader creativity by encouraging it in the workplace [ 23 , 24 ].

Significance of the study

The need to use natural resources more effectively by fostering sustainable development has arisen as a result of the fast growth, industrialization, and economic development occurring around the world [ 25 ]. Numerous research studies have emphasized the promotion of green creativity methods in manufacturing as a means of achieving long-term environmental goals. The essential strategy for encouraging creativity among followers is leadership. To this purpose, transformational leadership entails management that encourages workers’ inventiveness through energizing and group-goal-oriented conduct. By taking a creative approach to resolving environmental problems and encouraging an atmosphere where people may express their fullest level of creativity, green transformational leadership motivates staff to meet corporate goals [ 26 ].

Previous research has shown that green transformational leadership positively affects organizational greenness, which encourages green creativity inside the organization. Therefore, in order to combat the mounting threat of climate change, it is necessary to encourage employees to engage in eco-friendly practices at work [ 9 , 27 ]. By creating an environment that is favorable and supportive of organizational behavior that is green, transformational leadership plays a significant role [ 28 ]. Additionally, it is asserted that transformational leadership is a major factor in encouraging staff innovation [ 27 ].

Followers develop inspiring ideas as a result of the transformational leader’s charm, earning them respect and subsequently their allegiance. Instilling a sense of connection in their followers through personalized consideration enables the transformational leader to foster the growth of mutual care [ 28 ].

In addition, the transformational leader describes the path through which the vision can be realized with the help of inspirational motivation and giving the organization a clear direction. The ability of a transformational leader to stimulate the mind enables them to inspire the cognitive talents of their followers, which fosters the expansion and development of followers’ creative capacities. Additionally, transformational leaders foster employee creativity by empowering them to take on new initiatives and encouraging, assisting, and supporting them in doing so [ 26 , 29 ].

Aim of the study

Primary aim.

To investigate the influence of green transformational leadership educational intervention on nurse managers’ green behavior and creativity.

Secondary aim

To evaluate nurse managers’ knowledge of green transformational leadership skills.

To investigate nurse managers’ behavior toward green transformational leadership before and after educational intervention.

To evaluate the effectiveness of green transformational leadership educational intervention on green behavior and green creativity among nurse managers.

Hypotheses of the study :

Nurse managers’ knowledge about green transformational leadership will have improved after educational intervention.

Nurse managers’ behavior toward green transformational leadership will have improved after educational intervention.

Green transformational leadership educational intervention positively relates to green behavior among nurse managers after intervention.

Green transformational leadership educational intervention positively relates to green creativity among nurse managers after intervention.

Theoretical framework

Green transformational leadership and nurse managers’ green behaviors.

Green transformational leadership had an impact on the green behaviors of the nurse manager; but, because leaders set an example for others, transformational leaders can also have an impact on the green behavior of those they follow by modeling green behavior. Additionally, managers who serve as role models for environmental issues and inspire their staff to follow suit by setting an example for green behavior are exhibiting the green idealized effect [ 30 ]. Like task-oriented leaders, green transformational leaders are focused on long-term, sustainable growth through encouraging people to act in a more environmentally friendly manner and integrating their own green values with the organization’s green values. This showed that transformational leaders have a significant role in driving employees’ behavior via inspiration, motivation, and satisfaction. The green transformational leaders inspired and promoted environmental behaviors, making it possible for staff members to understand the value of green behavior and that the company expects and supports it [ 31 ].

Green transformational leadership and nurse managers’ green creativity

The creative thinking of employees is positively impacted by transformational leadership when it comes to promoting green production. Green transformative leaders encourage creative thinking by motivating subordinates to express their opinions and gain a passion for ideas [ 32 ]. Also, present green opportunities and corporations can gain a competitive edge by projecting a more environmentally conscious image. Fostering staff members’ green creativity to generate innovation is one of nurse managers’ top priorities. In addition to providing the necessary context-specific tools to allow staff members to express their creative expectations, green transformational leadership cultivates a positive, supportive environment [ 33 , 34 ]. Managers’ green creativity is enhanced by green transformational leadership which supporting, encouraging, extending a helping hand, and building their confidence to take new initiatives. Green creativity, as an important component of workplace creativity, may be considered as the same activity. If an organization aspires to be more environmentally friendly while simultaneously empowering staff to participate in activities like training, it must create a structure that gives workers, such as trainees and opportunities [ 35 , 36 ].

Design, setting, and subject of the study

A quasi-experimental design was conducted using pre-test, post-test, and follow-up for one group. The study was conducted at Main Mansoura University Hospital (MMUH) and its three medical centers: the convalescence center, the specialized medical center, and the center of plastic and burn surgery.

All available nurse managers who were on duty at their place of work at the time of data collection were included in the study by using a convenience sample technique.

Sample size

Based on a review of past literature [ 37 ], reported that there was a high statistically significant negative correlation between challenges faced by nursing managers and their perception of organizational support ( p  < 0.001). The sample was calculated at power 80% and confidence level 95%, with the following equation N = [ Zα + Zβ / C] 2 + 3 where: Zα = The standard normal deviate for α = 1.9600. The Zβ = standard normal deviate for β = 0.8416 C = 0.5 * ln[(1 + r)/(1-r)] = 0.1789. The calculated sample was 105 and it was increased by 10% to avoid dropout so the total sample was 116 participants. All available nurses were first-line managers, or supervisors, who were on duty at their place of work at the time of data collection. They were included in the study if they agreed to participate in the research. Accordingly, 86 first-line nurse managers and 30 nurse supervisors agreed to participate in this research.

Inclusion criteria

Nurse managers of different ages, genders, and years of education, who had at least two years of experience, were invited to participate in the research. However, male nurse managers were few in the Mansoura University Hospital because the male gender have joined the nursing profession recently, thus few of them hold managerial positions.

Exclusion criteria

If the experience of nurse managers is less than two years.

Data collection

Instrument one.

The Green Transformational Leadership Knowledge Questionnaire (GTLKQ) was developed by the investigator. This instrument was used to evaluate nurse managers’ knowledge about green transformational leadership before and after educational intervention. (S F -1)

The GTLKQ was included in Personal data (6 items) including age, qualification levels, experience, marital status, work unit, and whether or not they have heard about green leadership and Transformational Leadership Knowledge Questionnaire which consisted of 10 multiple choice questions.

Green transformational Leadership Knowledge Questionnaire scoring system

The ten transformation leadership knowledge items were measured with a three-point Likert scale developed by the investigator as (0–2) with (0) for an Incorrect answer, (1) for a Correct but incomplete answer, and (2) for a Correct and complete answer. Summing these answers has yielded a total score for the GTLKQ in the range of 0–20. Accordingly, if the total knowledge score was 0–11, he/she was classified as having Poor Kn. If the total score was 12–15, he/she was classified as having Moderate Kn. And if the total score was 16–20, he/she was classified as having Good Kn. (S F -1)

Instrument two : [ 38 ] developed the Green Transformational Leadership Scale, which the investigator adapted to assess nurse managers’ perceptions toward green transformational leadership before and after educational intervention. It comprised six items and was scored on a five-point Likert scale, with 1 representing strongly disagree and 5 representing strongly agree.

Green transformational Leadership Scale scoring system

Six items were scored with a five-point Likert scale (1–5) with (1) for Strongly disagree, (2) for Disagree, (3) for Neutral, (4) for Agree, and (5) for Strongly agree. Adding these individual scores yielded a score for the questionnaire in the range of 6–30.

Instrument three : The Green Behavior Questionnaire (GBQ) was created by Zhang, Yang, Cheng, and Chen [ 38 ], and was adopted by the research team to assess nurse managers’ green behavior before and after implementing an educational intervention. The adapted GBQ was made up of 13 items divided into four dimensions: (a) green learning (3 items), (b) individual practice (4 items), (c) influencing others (3 items), and (d) organizational voices (3 items). Each item was scored using a five-point Likert scale, with 1 representing strongly disagree and 5 representing strongly agree.

Green Behavior Questionnaire scoring system

13 questions were scored on a five-point Likert scale (1–5) with (1) representing strongly disagree, (2) representing disagree, (3) representing neutral, (4) representing agree, and (5) representing strongly agree. These results were added yielding a questionnaire being graded on a scale of 13 to 65.

Instrument four

The researcher modified [ 39 , 40 ] Green Creativity Scale (GC) to assess nurse managers’ green creativity both before and after the implementation of an educational intervention.

Green Creativity Scale scoring system

Six items were captured using a five-point Likert scale (1–5) with (1) for Strongly disagree, (2) for Disagree, (3) for Neutral, (4) for Agree, and (5) for Strongly agree. The questionnaire was evaluated giving a score of 6–30.

Translation procedures and the tool’s validity and reliability

The four instruments of green transformational leadership knowledge, green transformational leadership, green behavior, and green creativity scale were translated into Arabic using the process of translation and back-translation [ 41 ]. The translated tools were reviewed by a panel of seven professors/assistant professors from the university’s nursing academic staff. Furthermore, the panel examined the measurement tools for back translation from Arabic to English and content and face validities. Nothing required modifications based on the panel’s recommendations. Utilizing reliability analysis, the instrument’s internal consistency was evaluated.

Reliability was estimated among 10 manager nurses using the test-retest method two weeks apart. Then Cronbach alpha reliability test was done using the SPSS software. Cronbach’s alpha coefficients were calculated for multipoint items to evaluate the measurement reliability. Cronbach’s alpha for each instrument was as follows: 0.84 for the first instrument (Green Transformational Leadership Knowledge Questionnaire) , 0.93 for the second instrument (Green Transformational Leadership Scale) , 0.86 for the third instrument (Green Behavior Questionnaire ), and 0.90 for the fourth instrument (Green Creativity Scale). The results of Cronbach alpha reliability test results for the four instruments indicated that they were reliable in detecting the objectives of the study.

Pilot study

Furthermore, an initial pilot study was conducted with 16 (13%) participants of the study population. The pilot study evaluated the study instruments’ readability, applicability, and time demand as well as their viability. The study results remained unchanged after the pilot study’s findings were integrated.

The researchers started collecting data from the nurse managers who met the inclusion criteria after receiving legal authorization (Ethical and Research Committee Decision No. 881–2022 and Hospital Administration approval,10- 2022). Researchers have met participants and held Telegram groups to obtain their cooperation, and verbal consent to be included in the study. Also, for ease of communication, appropriate session times were set and posters and videos related to the program sent. The study was carried out through interviewing, implementation, and evaluation.

Interviewing

Interviewing started at the end of August 2022 and ended at the end of September 2022. The educational program, its goal, the intervention, and the period of intervention one-month and three-month requirements were all explained to the study participants. The educational intervention was run twice. The total number of nurse managers was 116. So, it was divided into two groups based on the departments they worked in each time, each group consisted of between 50 and 60 nurse managers. The total duration (12 h theory) for each group was divided into six sessions with two hours for each session. The educational intervention was implemented in six sessions for each group and three sessions were conducted weekly. The intervention lasted for two weeks for each group (one month for two groups). Various methods of teaching (lecture, discussion, role-playing, brainstorming, video material, etc.) were utilized.

Implementation

Data was gathered by meeting nurse managers and explaining the study’s goal to them. They received assurances that the data would only be utilized for the study and that it would be used for scientific studies. To gather information about the nurse managers’ level of knowledge regarding green transformational leadership, a knowledge questionnaire was given to all of the nurse managers before the educational intervention started, after it had finished, and three months later.

Prior to creating the sessions, the researchers looked over a large body of research and evidence-based literature. Green transformational leadership, green behavior, and green creativity were all the subjects of interventions that were produced after a review of the literature, an analysis of assessment findings, and an evaluation of increasing gaps. (Details about the program S.F.2)

Evaluation of green transformational leadership educational intervention phase

At the conclusion of the educational intervention and three months later, nurse managers were given a chance to reassess their understanding of green transformational leadership and compare their results with the pre-test. The purpose, mediator, and three-month program results of the green transformational leadership educational intervention on the environmentally conscious actions and green thinking of nurse managers were evaluated. A time in December 2022 was used to fill in the follow-up questionnaire.

Statistical approach

Data was altered and coded to fit into a form that was specifically made for computer entry. The SPSS (Statistics Package for Social Science) package, version 22, was used to enter and analyze the data. Excel was used to create the graphics.

Quantitative data were presented by mean (X) and standard deviation (SD). A comparison of mean practice scores was made among nursing directors and supervisors’ pre-intervention and immediate post-intervention. Also, a comparison of mean practice scores among nursing directors and supervisors’ pre-intervention and follow-up was done using paired t-tests. In addition, a comparison was made of mean practice scores among head nurses’ pre-intervention and immediate post-intervention. Also, a comparison of mean practice scores among head nurses’ pre-intervention and follow-up was done by using a paired t-test. Similar patterns were used in green behavior by using paired t-tests as well as green creativity using paired t-tests.

Qualitative data related to knowledge about green transformational leadership skills, quantity, and percentage were displayed as frequency distribution tables. Chi-square analysis was used to examine it. The Fisher Exact test (if the table had four cells) or the Likelihood Ratio (LR) test (if the table had more than four cells) was applied, if the anticipated value of any cell in the table was less than 5. For all significant tests, the level of significance was fixed at P  < 0.05.

Table  1 Contains personal characteristics of studied nurse managers and shows that the nurse managers age was 40.2 ± 5.7 Y. All of the participants were female (100%) and the majority (96.6%) were married. Most nurse managers had a bachelor’s degree (90.5%) and the majority were first line managers (74.1%), while the lowest (25.9%) were nursing supervisors.

Table  2 Demonstrates the effect of the instructional intervention program on nursing managers’ percentages of green transformational leadership knowledge when measured before the educational intervention, immediately post-intervention, and follow-up three months later. Both immediate post-intervention and follow-up results revealed a highly significant improvement in the green transformational leadership knowledge levels ( p  < 0. 001). The immediate post-intervention ‘good knowledge’ responses increased from 2.6% pre-intervention to 93.1% immediate post-intervention. The follow-up intervention program ‘good knowledge’ responses increased from 2.6% pre-intervention to 90.5% at follow-up.

Table  3 provides a comparison of green transformational leadership knowledge among nurse managers at pre-intervention, post-intervention, and follow-up. This table shows that the overall knowledge score of nurse managers increased significantly at post-intervention and follow-up (19.7 and 19.3; respectively) compared to 2.1 in the pre-intervention. In addition, there was a highly significant difference between post and follow-up intervention for each of the nurse supervisors and head nurses.

Table  4 demonstrates the efficacy of the green transformational leadership educational intervention for the green transformational leadership practice of nurse managers. Post-intervention and follow scores revealed a highly significant improvement ( p  < 0. 001) in green transformational leadership practice. Among nursing supervisors, the immediate post-intervention total mean practice increased from 14.5 ± 1.8 pre-intervention to 28.3 ± 1.02 post-intervention, and the difference was highly significant statistically ( P  < 0. 001). A similar trend was observed among head nurses, where the immediate post-intervention total mean practice increased from 13.1 ± 1.1 pre-intervention to 28.6 ± 0.9 post-intervention, and the difference was highly significant statistically ( P  < 0. 001). Similar trends were observed among nurse managers concerning the pre-green transformational leadership intervention and follow-up mean practices, and the difference was highly statistically significant ( p  < 0. 001) for nursing supervisors as well as head nurses.

Table  5 presents mean scores of the green behavior dimensions and total green behavior, as well as green creativity among nurse managers at pre-intervention, immediate post-intervention, and follow-up. This table shows a statistically significant difference between nurse managers’ knowledge of green behavior’ dimensions and total green behavior between pre-and post-intervention and between pre-intervention and follow-up. Nurse manager’s knowledge levels increased after the intervention. Moreover, there was a large effect of the intervention on nurse managers’ knowledge. Also, there was a statistically significant difference between nurse managers’ knowledge between post-intervention and follow-up.

Table  6 ; Fig.  1 show the level of significance and total mean score regarding pre-intervention, post-intervention, and follow-up green transformational leadership on green behavior among nurse managers. This highlighted the efficacy of the green transformational leadership educational intervention on the green behavior of the nurse managers. Post-intervention and follow-up revealed a highly significant improvement ( p  < 0. 001) in the different dimensions of green behavior as well as total green behavior. The mean difference between pre- and immediate post-intervention total behavior responses = -35.8, with SD = 2.2, and 95%. Confidence interval of the difference − 36.2 to − 35.4. A similar trend was observed concerning the pre-intervention and follow-up on green behavior responses, and the difference was highly statistically significant ( p  < 0. 001) for each. This result confirmed this study’s third hypothesis that “green transformational leadership educational intervention positively relates to green behavior among nurse managers after intervention”.

Table  7 ; Fig.  2 show the level of significance and total mean score regarding pre-intervention, post-intervention, and follow-up green transformational leadership on green creativity among nurse managers. This highlighted the efficacy of the green transformational leadership educational intervention on the green creativity of the nurse managers. Post-intervention and follow-up scores revealed a highly significant improvement ( p  < 0. 001) in the different dimensions of green creativity as well as for total green creativity. The mean difference between pre and immediate post-program total behavior responses = -35.8, with SD =(2.2), and a 95%. Confidence interval of the difference = − 36.2 to − 35.4. A similar trend was observed concerning the pre-intervention and follow-up scores for green creativity, and the difference was highly statistically significant ( p  < 0. 001) for each. This result confirmed this study’s fourth hypothesis which stated “green transformational leadership educational intervention positively relates to green creativity among nurse managers after intervention”.

Effect of Green Transformational Leadership educational intervention program on nurse managers’ green behavior before, immediately post and follow up intervention ( N  = 116)

Effect of Green Transformational Leadership educational intervention program on nurse managers’ green creativity before, immediately post, and follow-up intervention ( N  = 116)

Transformational leaders play a critical role in the creation and development of a vision that inspires proactive action toward various tasks and the realization of environmental concerns and green projects. Additionally, transformational leaders assist in the development of the “creativity-enhancing forces” paradigm as well as the culture of new ideas [ 42 ]. The success and execution of creative business concepts heavily rely on the function of transformational leadership. In keeping with this idea, transformational leadership plays a critical role in fostering a sustainable environment [ 43 ]. According to [ 44 ], transformational leaders have four key behavioral traits that affect their capacity to empower followers: inspirational motivation, charismatic personality, individual attention, and cognitive stimulation.

Following the execution of the educational intervention on green transformational leadership, the current study’s findings indicated an improvement in head nurses’ overall awareness of green transformational leadership levels and their management strategies. This result is consistent with the findings of [ 45 ]. They stated that training is the most effective technique to broaden knowledge and change head nurses’ attitudes, values, and views. Additionally [ 46 ], ran a training course for first-line managers at Minia University Hospital, and they reported that it was successful in enhancing their knowledge and providing them with the support they required to carry out the management position successfully [ 47 ]. found that the educational program improved head nurses’ knowledge and emphasized the significance of their need for further training and abilities outside of what they gained in nursing school. The result was incongruent with [ 48 ] who stated that there were inadequate program changes. Furthermore, to increase program openness and replicability, planners for transformational leadership initiatives should create standard methods for designing and assessing their initiatives.

The results of this study also indicated that, compared to immediately following training, head nurses’ knowledge of green transformational leadership and related management practices slightly decreased three months later. It’s possible that some of the knowledge head nurses learned while implementing the program had been forgotten. These interpretations were corroborated by [ 49 ], who noted a deterioration in the knowledge and abilities of healthcare professionals at the National Taiwan University Hospital and emphasized the necessity for more frequent refresher training to maximize knowledge maintenance, also with [ 50 ]. In the same way [ 51 ], noted a modest reduction in nurses’ mean knowledge scores three months after program implementation compared to just after the program.

The results on green transformational leadership showed that head nurses’ employment of competitive strategies increased statistically significantly with the deployment of post-training strategies, although it remained their least favored form of green transformational leadership. This study suggested that, as a result of the program’s execution, head nurses became more conscious of and adept at using their influence. They also mastered acting with more assurance and confidence. This interpretation is supported by [ 52 ] who noted the highly statistically significant improvement and added that green transformational leadership was a crucial part of the organizational context of institutions and was concerned with putting into practice modern strategies that are attentive to environmental issues as well as increasing productivity and developing performance. Similarly [ 53 ], discovered a significant and favorable influence with regard to green transformational leadership. Moreover [ 54 ], findings showed that transformative leadership has a beneficial effect on the efficacy of leadership.

These findings have shown that head nurses should consistently implement in-service and ongoing training programs [ 55 ]. observed considerable improvement in nurse managers’ levels of utilizing competing styles post-program compared with pre-program, which lends credence to this finding. Furthermore, this result is congruent with [ 56 ] who evaluated the transformational leadership behaviors of leaders and the independent motivation of their subordinates both before and after training. The findings indicate that following the intervention, there were significant effects in the organization as measured by the subordinates’ ratings of the transformational leadership behaviors of the leaders and their self-reported autonomous motivation. This study provides theoretical insights into how transformational leadership in leaders can be enhanced or developed, which is advantageous for encouraging environmental sustainability activities inside organizations and improving employee well-being, regarding the head nurses’ overall green behavior as well as the green behavior dimensions.

According to the results of the current study, utilizing a post-training approach resulted in a statistically significant rise in the use of positive aspect strategies by head nurses. This might be attributed to the fact that the head nurses recognized the importance of green transformational leader concerns, or it could be that the training inspired head nurses to have confidence in their staff members and allow them to participate in decision-making. The findings of this study were intriguing in that they showed that, compared to a pre-training strategy, the positive aspect strategy remained high three months after deployment, but that it was slightly less than the post-training strategy. This outcome is in line with the findings of [ 57 ], who found that the program resulted in the enhancement of environmentally friendly behavior. Additionally [ 58 ], noted that leadership had a large and favorable impact on employee green behavior. The results also showed that there was no correlation between employee green behavior and environmental knowledge. This finding differs from that of [ 59 ], who discovered that workplace social context influences employees’ green behavior in a favorable but insignificant way. As a result, it is concluded that workplace social context can influence an employee’s green behavior. The results also pointed to the need for managers of the organization to make investments in raising staff understanding of environmentally friendly behavior through environmental training.

With regard to green creativity, the current study revealed a highly statistically significant rise in the usage of green transformational leadership strategies, and head nurses tended to apply them at a neutral level following the training strategy. The chief nurses continued to use the green transformational leadership approach heavily in the follow-up assessment. This could be explained by the fact that head nurses recognized the value of developing strong supervisory relationships with their nurses as a part of their duties and learned how to do so in the green transformational leadership education program. As a result, head nurses began to show greater concern and interaction with staff nurses by developing a connection with them, offering guidance and support, mentoring them to develop their abilities, and scheduling time to reflect on work and personal matters. All of this increased the head nurse’s green creativity. This finding supports the claims made by [ 38 , 60 ], who argued that idealized persuasion, a commitment to environmental goals, an environmental vision, high environmental performance standards, intellectual reward, and individualized consideration can motivate staff to conduct new research and engage in environmentally friendly creative activities.

In relation to the green transformational leadership educational intervention, there was a good relationship between it and the green behavior of head nurses. The post-intervention and follow-up intervention programs showed a highly significant improvement ( p  < 0.0001) in both the individual green behavior aspects and overall green behavior. This may be a result of the leadership behaviors of those who inspire followers to perform above and beyond accepted levels of environmental performance. The findings of this study are consistent with those of [ 61 ] who investigated the connections between green transformational leadership, green human resource management techniques, and employees’ green behavior. They argued that these associations prove the beneficial connections between green transformational leadership and green behavior regarding green transformational leadership educational intervention on green creativity among head nurses. According to the current study, there was a statistically significant improvement after the educational intervention for total green transformational leadership and total green creativity among head nurses. The effectiveness of the educational intervention for green transformational leadership is favorably correlated with green creativity among head nurses. This might be explained by the study’s findings, which showed that employees’ contributions and resource acquisition led to improvements that allowed for original problem-solving. By integrating their resources, leaders can inspire their teams to work creatively and collaboratively on initiatives, which will boost their subordinates’ sense of responsibility and sense of shared purpose. This outcome is consistent with research by [ 62 ], who looked at how green leadership might inspire green innovation in university students. Students’ green creativity was greatly influenced by both green transformational leadership and green transactional leadership. Additionally, student creativity in developing green products and processes can be accomplished through the faculty members’ green leadership style. These findings concurred with [ 63 ] analysis of the function that green transformational leadership plays in encouraging green creativity through green organizational identity. They found that green transformational leadership had a beneficial impact on green organizational identity, which encouraged green creativity within the organization, by their 250 direct superiors.

Additionally [ 64 ], researched the relationship between green transformational leadership and employee green creativity and concluded that there was a positive correlation. In addition [ 3 ], asserted that green transformational leadership bolstered green innovation directly. Managers should be encouraged to improve their leadership style in order to encourage higher levels of green creativity, according to [ 65 ] study of the ongoing effects of green transformational leadership and green employee creativity among 150 employees. Additionally [ 66 ], demonstrated that the association between transformational leadership and innovative behavior of employees was positively modulated and mediated by knowledge sharing.

Conclusion and recommendations

Knowledge, attitude, and behavior were all impacted by the educational intervention known as green transformational leadership. The program had shown a highly significant improvement ( p  < 0.0001) in both the overall and individual characteristics of green behavior. The program had a significant post-intervention impact. This study recommended that hospital directors receive training in transformational leadership to improve and enhance their managerial creativity skills in several ways:

By developing a clear vision and mission, preserving steadfast values and high standards, having a strong sense of purpose, and having faith in both oneself and others, a leader must be able to motivate others. Additionally, they must demonstrate the importance of the human element in development and advancement by responding to individuals’ needs, maximizing their potential, and supporting them as they work to achieve their objectives.

Leaders must explore innovative ideas and tactics in order to successfully achieve a mission. For this, it is necessary to exude charisma, set an example of desirable behavior, inspire the team, and provide support for their creativity and intellectual stimulation.

In order to maintain consistency between their words and deeds, leaders must exhibit personal qualities including the capacity to concentrate, pay attention, adapt, and take risks. To boost morale among the team members, they must also serve as an example of how to manage workloads, communicate effectively, and reach out to others. They must also maintain a high level of harmony and collaboration within the group. Correlational and quasi-experimental study approaches are needed for future studies to investigate aspects that improve transformational leadership ability.

The concept of “Green Transformational Leadership” refers to leadership behaviors and strategies aimed at promoting environmental sustainability and responsibility within an organization or a specific context. In the case we mentioned, it involves implementing educational interventions targeted at nurse managers to enhance their understanding and adoption of green practices, as well as fostering green behavior and creativity among them. In summary, the paper highlights the pivotal role of nurse managers in fostering green transformational leadership and promoting environmentally sustainable practices within healthcare settings. Nursing management should leverage the insights from this study to develop tailored strategies for educating, empowering, and supporting nurse managers in leading green initiatives and driving positive environmental change.

Directions for future research

Through future research, this conceptual model should be expanded upon in other fields, such as information technology. Additionally, staff nurses’ opinions of leadership style should be taken into account in future studies, as should their perspectives. Finally, the impact of a single leadership style—green transformational leadership—has been discovered by this research. Therefore, additional leadership philosophies; like servant leadership and inclusive leadership, ought to be explored in future research.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. All data generated or analyzed during this research are included in this manuscript. The authors confirm that all methods were performed in accordance with the relevant guidelines and regulations.

Xiao X, Zhou Z, Yang F, Qi H. Embracing responsible leadership and enhancing organizational citizenship behavior for the environment: a social identity perspective. Front Psychol. 2021;12:632629.

Article   PubMed   PubMed Central   Google Scholar  

Mansoor A, Farrukh M, Lee JK, Jahan S. Stimulation of employees’ green creativity through green transformational leadership and management initiatives. Sustainability. 2021;13:7844.

Article   Google Scholar  

Li W, Bhutto TA, Xuhui W, Maitlo Q, Zafar AU, Bhutto NA. Unlocking employees’ green creativity: the effects of green transformational leadership, green intrinsic, and extrinsic motivation. J Clean Prod. 2020;255:120229.

Saleh SM, El-Gilany M, Abdelhamid AHN, Abdelbaset Hamed Z, S., Said E, Elsabahy H. Effect of authentic Leadership Training Program of Head nurses on Creativity and Motivation of nurses Staff. Egypt J Health Care. 2021;12(3):600–14.

Mukonza C, Swarts I. (2019). Examining the Role of Green Transformational Leadership on Promoting Green Organizational Behavior. Contemporary Multicultural Orientations and Practices for Global Leadership. Tshwane University of Technology, South Africa. Pages: 25. https://doi.org/10.4018/978-1-5225-6286-3.ch01 .

Hadi NU, Rasool F. Environmental transformational Leadership and Employee Pro-environmental behaviours: the bridging role of Autonomous Motivation. Abasyn J Social Sci. 2017;10:36–47. Special Issue.

Google Scholar  

Al-Swidi A, Kaid HM, Gelaidan, Redhwan Mohammed S. The joint impact of green human resource management, leadership and organizational culture on employees’ green behavior and organizational environmental performance. J Clean Prod. 2021;316:128112.

Torun T. The effects of green transformational Leadership on the Green Behavior of businesses, the Environment and the Green performance. J Social Sci Inst. 2023;61:31–53.

Ones DS, Dilchert S. (2012). Chapter Five, Employee Green Behaviors. In Managing Human Resources for Environmental Sustainability, 1st ed. Edited by Susan E. Jackson, Deniz S. Ones and Stephan Dilchert. New York: Jossey-Bass, pp. 85–116.

Omarova L. and Sung-Jun Jo. 2022. Employee pro-environmental behavior: The impact of environmental transformational leadership and GHRM. Sustainability 14: 2046.

Robertson JL, Carleton E. (2018): Uncovering how and when environmental leadership affects employees’ voluntary pro-environmental behavior. J. Leadership. Organ. 2018, 25, 197–210.

Wang X, Zhou K, Liu W. Value congruence: a study of green transformational leadership and employee green behavior. Front Psychol. 2018;9:1946. https://doi.org/10.3389/fpsyg.2018.01946 .

Li M, Gong Z, Gul Gilal F, Van Swol L, Xu J, Li F. The moderating role of ethical Leadership on nurses’ Green Behavior intentions and Real Green Behavior. Hindawi BioMed Res Int. 2021;2021(Article ID 6628016):7pages. https://doi.org/10.1155/2021/6628016 .

Norton TA, Zacher H, Parker SL, Ashkanasy NM. Bridging the gap between green behavioral intentions and employee green behavior: the role of green psychological climate. J Organizational Behav. 2017;38:7, 996–1015.

Yang ZL, Cheng X, Chen F. Int J Environ Res Public Health. 2021;18(4):1669. https://doi.org/10.3390/ijerph18041669 .

Lu H, Xu W, Cai S, Yang F, Chen Q. Does top management team responsible leadership help employees go green? The role of green human resource management and environmental felt?responsibility. Corp Soc Responsib Environ Manag. 2022;29:843–59. https://doi.org/10.1002/csr.2239 .

Al-Ghazali BM 1, Gelaidan HM, Shah S, Amjad R. (2022). Green transformational leadership and green creativity? The mediating role of green thinking and green organizational identity in SMEs. https://doi.org/10.3389/fpsyg.2022.977998 .

Ahmad N, Ullah Z, AlDhaen E, Han H, Scholz MA, CSR. (2022) perspective to foster employee creativity in the banking sector: The role of work engagement and psychological safety. J. Retail. Consum. Serv. 2022, 67, 102968.

Koseoglu G, Liu Y, Shalley CE. (2017): Working with creative leaders: Exploring the relationship between supervisors’ and subordinates’ creativity. Leaders. Q. 2017, 28, 798–811.

Li W, Xuhui W, Bhutto T, Zafar A, Bhutto N, Maitlo Q. Unlocking employees’ green creativity: the effects of green transformational leadership, green extrinsic, and motivation intrinsic. J Clean Prod. 2020;254:120229. https://doi.org/10.1016/j.jclepro.2020.120229 .

Begum S, Awan U, Xia E, Ashfaq M. Does green transformational leadership lead to green innovation? The role of green thinking and creative process engagement. Bus Strat Environ. 2022;31:580–97. https://doi.org/10.1002/bse.2911 .

Al-Ghazali B, Gelaidan H, Shah S, Amjad R. Green transformational leadership and green creativity? The mediating role of green thinking and green organizational identity in SMEs. Organizational Psychol. 2022;13. https://doi.org/10.3389/fpsyg.2022.977998 .

Suifan TS, Abdallah AB, Al Janini M, Tang G. Yu, B., Cook.

Zhang W, Xu F, Wang X. (2020). How green transformational Leadership affects Green Creativity: creative process Engagement as intermediary bond and Green Innovation Strategy as Boundary Spanner, 12, 3841. https://doi.org/10.3390/su12093841 http://www.mdpi.com/journal/sustainability .

Eweje G, Sajjad A, Nath SD, Kobayashi K. Multi-stakeholder partnerships: a catalyst to achieve sustainable development goals. Mark Intell Plann. 2021;39(2):186–212.

Begum S, Ashfaq M, Xia E, Awan U. Does green transformational leadership lead to green innovation? The role of green thinking and creative process engagement. Bus Strategy Environ. 2022;31(1):580–97.

Paillé P, Boiral O. Pro-environmental behavior at work: construct validity and determinants. J Environ Psychol. 2013;36:118–28.

Hassan Helaly S, Alenezi A, Elsabahy E, H., Saleh M, Saleh M. Effects of Head nurses’ Leadership behaviors and Social Intelligence on Staff nurses’ job involvement. Egypt J Health Care. 2022;13(4):1308–22.

Saad Alessa G. The dimensions of transformational leadership and its organizational effects in public universities in Saudi Arabia: a systematic review. Front Psychol. 2021;12:682092.

Sobaih AE, Gharbi H, Abu Elnasr AE, Hasanein A. (2022). Going Green together: effects of green transformational Leadership on Employee Green Behavior and Environmental Performance in the Saudi Food Industry.12, 1100. https://doi.org/10.3390/Agriculture12081100 .

Tosun C, Bilim Y, Parvez M. Effects of green transformational leadership on green performance of employees via the mediating role of corporate social responsibility. Int J Hosp Manag. 2022;105:103217.

Monowar M, Fan L, Uddin M. (2019). The influence of transformational leadership on employees’ creative process engagement: A multi-level analysis. Manag. Decis. 2019, 57, 742–763.

Ahmed NA-E, Abdel-Latif Abdel-Sattar Z, S., Saleh M, Saleh M. Job satisfaction, non-nursing tasks and nursing tasks left undone among nurses at Zagazig University Hospitals in Egypt. Egypt J Health Care. 2020;11(4):859–69.

Al-Ghazali BM, Amjad R, Gelaidan H, Shah. Green transformational leadership and green creativity? The mediating role of green thinking and green organizational identity in SMEs. Front Psychol. 2022;13:977998. https://doi.org/10.3389/fpsyg.2022.977998 .

Sidney M, Ferasso M, Saeed A, Wang N, Nazir M. Continuous effects of green transformational Leadership and Green Employee Creativity: a moderating and mediating prospective. Front Psychol. 2022;13:840019doi. https://doi.org/10.3389/fpsyg.2022.840019 .

Hossny EK, Morsy SM, Ahmed AM, Saleh MSM, Alenezi A, Sorour MS. Management of the COVID-19 pandemic: challenges, practices, and organizational support. BMC Nurs. 2022;21(1):1–13.

Jung DI, Chow C, Wu A. The role of transformational leadership in enhancing organizational innovation: hypotheses and some preliminary findings. Leadersh Q. 2003;14(4–5):525–44.

Zhang B, Yang L, Cheng X, Chen F. How does employee green behavior impact employee well-being? An empirical analysis. Int J Environ Res Public Health. 2021;18(4):1669.

Chen YS, Chang CH. The determinants of green product development performance: green dynamic capabilities, green transformational leadership, and green creativity. J Bus Ethics. 2013;116:107–19.

Sun X, El Askary A, Meo MS, Zafar NUA, Hussain B. Green transformational leadership and environmental performance in small and medium enterprises. Economic Research-Ekonomska Istraživanja. 2022;35(1):5273–91.

Brislin RW. Back-translation for cross-cultural research. J ofCross-Cultural Psychol. 1970;1(3):185–216. https://doi.org/10.1177/135910457000100301 .

Al-Ghazali BM, Gelaidan HM, Shah SHA, Amjad R. Green transformational leadership and green creativity? The mediating role of green thinking and green organizational identity in SMEs. Front Psychol. 2022;13:977998.

Hamzah E, Okechukwu LE, Abdallah A, Amro A. The impact of transformational and authentic leadership on innovation in higher education: the contingent role of knowledge sharing. Telematics Inform. 2018;35(1):55–67.

Gab Allah AR. (2021, July). Challenges facing nurse managers during and beyond COVID-19 pandemic in relation to perceived organizational support. In Nursing Forum (Vol. 56, No. 3, pp. 539–549).

Saleh NE, Sleem WF, El-Shaer AM. Effect of clinical supervision program for head nurses on quality nursing care. IOSR J Nurs Health Sci. 2015;4(6):65–74.

Ali RM, Elmolla MA, Aref SM. Impact of transformational leadership training program on nurse’s unit manager behavior change. J Biology Agric Healthc. 2016;6(2):95–102.

Mohamed ZAEF, Elmolla MA, Abdeen MA. Effect of orientation program on competency of newly graduated nurses at Mansoura new general hospital. Zagazig Nurs J. 2016;12(1):225–39.

Lawrason SV, Shaw RB, Turnnidge J, Côté J. (2023). Characteristics of transformational leadership development programs: a scoping review. Eval Program Plan, 102354.

A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers. Resuscitation , 83 (9), 1055–1060.

Saleh SM, M., Elsabahy HES. Integrating sustainability development education program in nursing to challenge practice among nursing interns in health care. J Nurs Adm Manag. 2022;30(8):4419–29.

Abdel-Aziez SH, Ali SA, Metwally FG, Mohammed WM. (2016). Effect of an Evidence Based Practice Program on Nurse’s Knowledge and Practice. Zagazig Nursing Journal , 12 (1), 99–113. http://platform.almanhal.com/CrossRef/Preview/?ID=2 91372.

Suliman MA, Abdou AH, Ibrahim MF, Al-Khaldy DAW, Anas AM, Alrefae WMM, Salama W. Impact of green transformational Leadership on employees’ environmental performance in the Hotel Industry Context: does Green Work Engagement Matter? Sustainability. 2023;15(3):2690.

Cui R, Wang J, Zhou C. Exploring the linkages of green transformational leadership, organizational green learning, and radical green innovation. Bus Strategy Environ. 2023;32(1):185–99.

Shatila K, Agyei FB, Aloulou WJ. (2023). Impact of transformational leadership on leadership effectiveness: the mediating effect of emotional skills in the Lebanese small and medium-sized enterprises context. Journal of Enterprising Communities: People and Places in the Global Economy.

El-Fatah RA, Gad A, S. A., El-Demerdash SM. An educational program about nursing managers transformational leadership, conflict management styles and decision-making effectiveness. IOSR J Nurs Heal Sci. 2014;3(3):42–56.

Nduneseokwu CK, Harder MK. Developing environmental transformational leadership with training: leaders and subordinates environmental behavior outcomes. J Clean Prod. 2023;403:136790.

Article   CAS   Google Scholar  

Rachman SPD, Maryani E. (2018, April). Teachers’ and students’ green behaviour of Adiwiyata targeted school. In IOP Conference Series: Earth and Environmental Science (Vol. 145, No. 1, p. 012042). IOP Publishing.

He J, Morrison AM, Zhang H. Being sustainable: the three-way interactive effects of CSR, green human resource management, and responsible leadership on employee green behavior and task performance. Corp Soc Responsib Environ Manag. 2021;28(3):1043–54.

Ahmed M, Zehou S, Raza SA, Qureshi MA, Yousufi SQ. Impact of CSR and environmental triggers on employee green behavior: the mediating effect of employee well-being. Corp Soc Responsib Environ Manag. 2020;27(5):2225–39.

Singh SK, Del Giudice M, Chierici R, Graziano D. Green innovation and environmental performance: the role of green transformational leadership and green human resource management. Technol Forecast Soc Chang. 2020;150:119762.

Cahyadi A, Natalisa D, Poór J, Perizade B, Szabó K. Predicting the relationship between green transformational Leadership, Green Human Resource Management Practices, and employees’ Green Behavior. Administrative Sci. 2022;13(1):5.

Saif N, Goh GGG, Ong JW, Khan IU. Green transformational and transactional leadership in fostering green creativity among university students. Global J Environ Sci Manage. 2023;9(3):577–88.

Mittal S, Dhar RL. Effect of green transformational leadership on green creativity: a study of tourist hotels. Tour Manag. 2016;57:118–27.

Zhang W, Xu F, Wang X. How green transformational leadership affects green creativity: creative process engagement as intermediary bond and green innovation strategy as boundary spanner. Sustainability. 2020;12(9):3841.

Sidney MT, Wang N, Nazir M, Ferasso M, Saeed A. (2022). Continuous effects of green transformational leadership and green employee creativity: A moderating and mediating prospective. Frontiers in Psychology , 13 .

Choi SB, Kim K, Ullah SE, Kang SW. (2016). How transformational leadership facilitates innovative behavior of Korean workers: examining mediating and moderating processes. Personnel Rev.

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Acknowledgements

The authors would like to thank the Deanship of Scientific Research at Shaqra University for supporting this work. Also, we would like to thank the Deanship of Scientific Research at Zagazig University for supporting this work. And, we would like to thank the Deanship of Graduate Studies and Scientific Research, Taif University for supporting this work.

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The idea put out was conceived by M.SM and W. MS. The introduction sections were written by H.EE and W. MS. The methods part was written by M.SM, W. MS., S.A, and H.EE. M.SM, W. MS., ZN. and H.EE were responsible for collecting data, analysis, and writing of the results part. All authors have worked together on the discussion section. The final manuscript and writing of the article was contributed to by all authors (M.SM, H.EE, W. MS. ZN,,SM, AA and S.A), who also discussed the results. All authors replied to reviewers’ comments. The manuscript’s English language editing was done by M.SM, SM and AA After going over the reviewers’ comments, M.SM, H.EE, W. MS., ZN, SM, AA and S.A read the entire text. The final revised manuscript was read and approved by all authors.

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Moustafa Saleh, M.S., Elsabahy, H.E., Abdel-Sattar, S.AL. et al. Fostering green transformational leadership: the influence of green educational intervention on nurse managers’ green behavior and creativity. BMC Nurs 23 , 393 (2024). https://doi.org/10.1186/s12912-024-01991-0

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Here’s the latest news about a global outbreak of H5N1 bird flu that started in 2020, and recently spread among cattle in U.S. states and marine mammals across the world, which has health officials closely monitoring it and experts concerned the virus could mutate and eventually spread to humans, where it has proven rare but deadly.

A sign warns of a outbreak of bird flu.

June 5 A new study examining the 2023 bird flu outbreak in South America that killed around 17,400 elephant seal pups and 24,000 sea lions found the disease spread between the animals in several countries, the first known case of transnational virus mammal-to-mammal bird flu transmission.

May 30 Another human case of bird flu has been detected in a dairy farm worker in Michigan—though the cases aren’t connected—and this is the first person in the U.S. to report respiratory symptoms connected to bird flu, though their symptoms are “resolving,” according to the Centers for Disease Control and Prevention.

May 23 A new study with mice suggests that drinking infected milk can spread the disease—and that a certain type of pasteurization may not always be effective in killing the virus.

May 22 Michigan reported bird flu in a farmworker—the second U.S. human case tied to transmission from dairy cows—though the worker had a mild infection and has since recovered.

May 21 Australia reported its first human case of bird flu after a child became infected in March after traveling to India, though the child has since recovered after suffering from a “severe infection,” according to the Victorian Department of Health.

May 16 The USDA conducted a study, and discovered that after high levels of the virus was injected into beef, no trace was left after the meat was cooked medium to well done, though the virus was found in meat cooked to lower temperatures.

May 14 The Centers for Disease Control and Prevention released influenza A waste water data for the weeks ending in April 27 and May 4, and found several states like Alaska, California, Florida, Illinois and Kansas had unusually high levels, though the agency isn’t sure if the virus came from humans or animals, and isn’t able to differentiate between influenza A subtypes, meaning the H5N1 virus or other subtypes may have been detected.

May 10 The Food and Drug Administration announced it will commit an additional $8 million to ensure the commercial milk supply is safe, while the Department of Agriculture said it will pay up to $28,000 per farm to help mitigate the spread of the disease, totaling around $98 million in funds.

May 9 Some 70 people in Colorado are being monitored for bird flu due to potential exposure, and will be tested for the virus if they show any symptoms, the Colorado Department of Public Health told Forbes—it was not immediately clear how or when the people were potentially exposed.

May 1 The Department of Agriculture said it tested 30 grocery store ground beef products for bird flu and they all came back negative, reaffirming the meat supply is safe.

May 1 The Food and Drug Administration confirmed dairy products are still safe to consume, announcing it tested grocery store samples of products like infant formula, toddler milk, sour cream and cottage cheese, and no live traces of the bird flu virus were found, although some dead remnants were found in some of the food—though none in the baby products.

April 30 Wenqing Zhang, head of the World Health Organization's Global Influenza Programme, said during a news briefing "there is a risk for cows in other countries to be getting infected," with the bird flu virus, since it’s commonly spread through the movement of migratory birds.

April 29 The Department of Agriculture told Forbes it will begin testing ground beef samples from grocery stores in states with cow outbreaks, and test ground beef cooked at different temperatures and infected with the virus to determine if it's safe to eat.

April 24 The USDA said cow-to-cow transmission may be occurring due to the cows coming into contact with raw milk—and warned against humans and other animals, including pets, consuming unpasteurized milk to prevent potential infection.

April 18 Jeremy Farrar, chief scientist for the World Health Organization, said during a press conference the threat of bird flu spreading between humans was a “great concern,” since it’s evolved and has increasingly been infecting mammals (on land and sea), which means it could possibly spread to humans.

April 1 The CDC reported the second U.S. human case of bird flu in a Texas dairy farmer who became infected after contracting the virus from infected dairy cows, but said the person was already recovering.

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Can Bird Flu Spread Between Humans?

Bird flu doesn’t “transmit easily from person-to-person,” according to the World Health Organization. Bird flu rarely affects humans, and most previous cases came from close contact with infected poultry, according to the CDC. Because human-to-human spread of bird flu poses “pandemic potential,” each human case is investigated to rule out this type of infection. Though none have been confirmed, there are a few global cases—none in the U.S.—where human-to-human transmission of bird flu was thought to be “probable,” including in China , Thailand , Indonesia and Pakistan .

Is Bird Flu Fatal To Humans?

It is very deadly. Between January 2003 and March 28, 2024 there have been 888 human cases of bird flu infection in humans, according to a report by the World Health Organization. Of those 888 cases, 463 (52%) died. To date, only two people in the U.S. have contracted H5N1 bird flu, and they both were infected after coming into contact with sick animals. The most recent case was a dairy worker in Texas who became ill in March after interacting with sick dairy cows, though he only experienced pink eye. The first incident happened in 2022 when a person in Colorado contracted the disease from infected poultry, and fully recovered.

Is It Safe To Drink Milk Infected With Bird Flu?

Raw, unpasteurized milk is unsafe to drink, but pasteurized milk is fine, according to the FDA. Bird flu has been detected in both unpasteurized and pasteurized milk, but the FDA recommends manufacturers against making and selling unpasteurized milk since there’s a possibility consuming it may cause bird flu infection. However, the virus remnants in pasteurized milk have been deactivated by the heat during the pasteurization process , so this type of milk is still believed safe to consume.

Is It Safe To Consume Meat Infected With Bird Flu?

The CDC warns against eating raw meat or eggs from animals “confirmed or suspected” of having bird flu because of the possibility of transmission. However, no human has ever been infected with bird flu from eating properly prepared and cooked meat, according to the agency. The possibility of infected meat entering the food supply is “extremely low” due to rigorous inspection, so properly handled and cooked meat is safe to eat, according to the USDA. To know when meat is properly cooked, whole beef cuts must be cooked to an internal temperature of 145 degrees Fahrenheit, ground meat must be 160 degrees and poultry must be cooked to 165 degrees. Rare and medium rare steaks fall below this temperature. Properly cooked eggs with an internal temperature of 165 degrees Fahrenheit kills bacteria and viruses including bird flu, according to the CDC. “It doesn’t matter if they may or may not have [avian] influenza… runny eggs and rare pieces of meat” are never recommended, Francisco Diez-Gonzalez, director and professor for the Center for Food Safety at the University of Georgia, told Forbes. To “play it safe,” consumers should only eat fully cooked eggs and make sure “the yolks are firm with no runny parts,” Daisy May, veterinary surgeon with U.K.-based company Medivet, said .

What Are Bird Flu Symptoms In Humans?

Symptoms of bird flu include a fever, cough, headache, chills, shortness of breath or difficulty breathing, runny nose, congestion, sore throat, nausea or vomiting, diarrhea, pink eye, muscle aches and headache. However, the CDC advises it can’t be diagnosed based on symptoms alone, and laboratory testing is needed. This typically includes swabbing the nose or throat (the upper respiratory tract), or the lower respiratory tract for critically ill patients.

How Is Bird Flu Affecting Egg Prices?

This year’s egg prices have increased as production decreased due to bird flu outbreaks among poultry, according to the USDA. A dozen large, grade A eggs in the U.S. costed around $2.99 in March, up almost a dollar from the fall. However, this price is down from a record $4.82 in January 2023, which was also spiked by bird flu outbreaks . Earlier this month, Cal-Maine Foods—the country’s largest egg producer—temporarily halted egg production after over one million egg-laying hens and chickens were killed after being infected with bird flu.

Why Do Poultry Farmers Kill Chickens With Bird Flu?

Once chickens have been infected with bird flu, farmers quickly kill them to help control the spread of the virus, since bird flu is highly contagious and fatal in poultry. The USDA pays farmers for all birds and eggs that have to be killed because of bird flu, as an incentive to responsibly try and curb the spread of the disease. The USDA has spent over $1 billion in bird flu compensation for farmers since 2022, according to the nonprofit Food & Environment Reporting Network.

Is There A Vaccine For The Bird Flu (h5n1)?

The FDA has approved a few bird flu vaccines for humans. The U.S. has a stockpile of vaccines for H5N1 bird flu, but it wouldn’t be enough to vaccinate all Americans if an outbreak were to happen among humans. If a human outbreak does occur, the government plans to mass produce vaccines, which can take at least six months to make enough for the entire population. CSL Seqirus, the maker of one of the approved vaccines, expects to have 150 million vaccines ready within six months of an announcement of a human bird flu pandemic. Although there are approved vaccines for other variants designed for birds, there are none for the H5N1 variant circulating. However, the USDA began trials on H5N1 animal-specific vaccines in 2023.

Key Background

As of May 30, more than 92 million poultry (primarily chickens) in 48 states have been euthanized because of bird flu since 2022, and 57 dairy cow herds across nine states have tested positive, according to data from the CDC (unlike chickens, cows appear to recover from the virus). The USDA believes wild migratory birds are the original source of the cow outbreaks that recently has experts concerned it may mutate and spread more easily in humans, though the CDC said its risk to the public remains low . Farrar called the cattle infections in the U.S. a “huge concern,” urging public health officials to continue closely monitoring the situation “because it may evolve into transmitting in different ways.” The increased number of mammal bird flu infections since 2022 “could indicate that the virus is looking for new hosts, and of course, moving closer to people,” Andrea Garcia, vice president of science, medicine and public health for the American Medical Association, said . The first report of a walrus dying from bird flu was detected in April on one of Norway’s Arctic Islands, and the first U.S. dolphin infected with bird flu died back in 2022, according to a report published April 18. More than 10 human bird flu cases were reported to the World Health Organization in 2023, and all but one survived. Bird flu has devastated bird populations, and 67 countries reported the deaths of 131 million poultry in 2022 alone. Although bird flu typically infects wild birds and poultry, it’s spread to other animals during the outbreak, and at least 10 countries have reported outbreaks in mammals since 2022. Around 17,400 elephant seal pups died from bird flu in Argentina in 2023, and at least 24,000 sea lions died in South America the same year. Besides cattle, bird flu has been detected in over 200 other mammals—like seals, raccoons and bears—in the U.S. since 2022. Although rare, even domestic pets like dogs and cats are susceptible to the virus, and the FDA warns against giving unpasteurized milk to cats to avoid possible transmission.

On June 5, WHO confirmed the first human death of a strain of bird flu that’s never before been seen in humans and is separate from H5N1. A 59-year-old man in Mexico contracted H5N2, and died on April 24 after being hospitalized and developing a fever, diarrhea, nausea, shortness of breath and general discomfort. Cases of H5N2 have been reported in poultry in Mexico, but the man had no history with poultry or animals, WHO said. It’s unclear how he became infected. He was bedridden for weeks prior to the infection, and suffered from several other health conditions.

Further Reading

Another Bird Flu Variant Reaches Humans: What To Know About H5N2—After First-Ever Confirmed Death

WHO Warns Threat Of Bird Flu Spreading To Humans Is ‘Great Concern’ (Forbes)

One In Five Milk Samples From Across US Had Traces Of Bird Flu Virus, FDA Says (Forbes)

Can Pets Get Bird Flu? Here’s What To Know (Forbes)

Avian H5N1 (Bird) Flu: Why Experts Are Worried—And What You Should Know (Forbes)

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